Lashanta Rice - Academia.edu (original) (raw)
Papers by Lashanta Rice
Purpose: The purpose of this study was to explore community perceptions of cancer risk, environme... more Purpose: The purpose of this study was to explore community perceptions of cancer risk, environmental hazards, and health behaviors in an at-risk population. Methods: A convenience sample of residents in Metropolitan Charleston, South Carolina was recruited at local venues and community events to complete a 59-item health survey. Survey questions explored 6 domains: sociodemographic characteristics, environmental health risks, perceived cancer risk, health behaviors, self-efficacy, and social support which were adapted from existing surveys. Paper and online surveys were distributed from March to September 2013. SAS 9.3 was used to perform descriptive statistics. Results: Survey respondents (N=405) were 81% female (n=322) and 19% male (n=75), employed (60%), owned their home (60%), were college graduates (52%) with an annual household income of $20,000-49,999 and 18-87 years of age. Overall, respondents were non-smokers (88%), considered themselves to be overweight (59%), engaged in...
Research exploring the effects of travel for healthcare services are growing rapidly, particularl... more Research exploring the effects of travel for healthcare services are growing rapidly, particularly as GIS becomes more used by public health professionals. Mixed method explorations on the effects of travel impediments among patients suffering from rheumatic diseases have been very limited, however. Research has consistently indicated a shortage in rheumatologists, resulting in patients potentially having to travel long distances for care. Rheumatic diseases can cause extreme joint discomfort, making travelling long distances difficult; thus, more research exploring travel burden among patients suffering from rheumatic diseases is warranted. In this study, we conducted in-depth interviews with patients suffering from systemic lupus erythematous (SLE) as a pilot study, Ten (10) interviews were conducted among participants in the Medical University of South Carolina's SLE database. Grounding our research are two theoretical frameworks, both intersectionality and situational analys...
Studies have demonstrated an association between chronic illnesses and exposure to toxic environm... more Studies have demonstrated an association between chronic illnesses and exposure to toxic environmental conditions. We used Photovoice to document community members' perceptions of environmental factors that influence health and contribute to health disparities. We conducted a formative assessment of community risks to inform the development of an environmental health survey on cancer and environmental risk perceptions. Homogenous and convenience sampling were used to recruit community members (n=14) across North Charleston, South Carolina. Participants documented positive and negative environmental features of their neighborhoods using Photovoice. Group consensus was employed to identify and confirm photo themes. Research staff identified 10 emergent themes from the photos. They included: housing/dwellings, industrial, hazards/pollution, beautification, places of worship, human and social services, businesses/schools, construction, natural environment, and other. Photovoice resu...
Purpose: To describe the process evaluation of a pilot Summer Enrichment program (SEP) at the Uni... more Purpose: To describe the process evaluation of a pilot Summer Enrichment program (SEP) at the University of South Carolina that provided opportunities and experiences for underrepresented undergraduate students to gain exposure to research careers in environmental health sciences and environmental justice. The project also provided graduate students from the University valuable practice in program planning, implementation and evaluation. Methods: Qualitative data collection methods were used to conduct a process evaluation of this pilot project, primarily from the perspective of the undergraduate students who participated and the graduate students who planned and implemented the program. Data were collected using two methods, weekly journals and open-ended surveys, which measured the usefulness of program experiences to career intentions and the feasibility of such a project. Results: The results indicated that the SEP provided both undergraduate and graduate level students the oppo...
Purpose: A considerable body of environmental justice (EJ) research finds that neighborhoods with... more Purpose: A considerable body of environmental justice (EJ) research finds that neighborhoods with lower environmental quality may be overrepresented by ethnic minorities and economically disadvantaged populations. The quality of the physical environment is one of the factors that contribute to high levels of community stress and leads to disparities in health. We assessed the physical and social features that contribute to poor health. Methods: We trained 10 community leaders and stakeholders to conduct community block assessments (CBA) identifying physical and social features and categorizing and mapping non-residential characteristics in their neighborhoods. A structured assessment tool was adapted from the Johns Hopkins Neighborhood Inventory for Environmental Typology (NiFeTy) and modified to best suit the rural nature of North Charleston. A total of 62 blocks in four target communities were assessed and compared to each other on salutogenic and pathogenic features. Results: Com...
American journal of men's health, Jan 3, 2015
Since prostate cancer continues to disproportionately affect African American men in terms of inc... more Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 (n = 132). Overall, 64% of men (n = 85) reported that they had ever had a PSA test; the mean (SD) age for first use of PSA testing was 47.7 (SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annua...
Background: Disadvantaged and low-income populations bear an unequal burden of air toxics exposur... more Background: Disadvantaged and low-income populations bear an unequal burden of air toxics exposure and risk due to the spatial distribution of environmental contaminants. Objectives: The purpose of this study was to assess the relative contribution of various pollution sources to cancer risk across socioeconomic and racial characteristics in Metropolitan Charleston, South Carolina. Methods: Cancer risk estimates were extracted from the National-Scale Air Toxics Assessment and linked with 2000 Census tract data. Data linking and statistical analyses were performed in R. Maps were developed in ArcGIS version 10. Relative risk and 95% confidence intervals of elevated risk were calculated across exposure source and quartiles of socioeconomic and racial characteristics. Chi-square tests were used to test the variance in the percentage of high cancer risk between quartiles. Results: Background and on-road source risk were significantly higher than risks from other sources. Percent non-whi...
Background: Studies have demonstrated an association between perceptions and environmental health... more Background: Studies have demonstrated an association between perceptions and environmental health risk and cancer risk separately, but a paucity of research has explored perceptions as a concurrent contributor of health disparities in at-risk populations. We explored the relationship between perceived cancer (PCR) and socioeconomic factors, neighborhood environment, and risk-reducing health behaviors. Methods: A 59-item community environmental health survey was administered in Metropolitan Charleston (Berkeley, Charleston, and Dorchester Counties) from March 2013 to September 2013. A convenience sample of 405 adults was recruited at local venues (e.g., libraries, housing authority, and hair salons) and community events. Multivariate logistic regressions were performed in SAS 9.3. Results: Respondents (N=405) were 99% African American, 81% female (n=322), 19% male (n=75), and ranged from 18 to 87 years of age. Low PCR when measured by likelihood of cancer was associated with non-alco...
Cancer Epidemiology Biomarkers & Prevention, 2014
Environmental Research, 2015
Populations of color and low-income communities are often disproportionately burdened by exposure... more Populations of color and low-income communities are often disproportionately burdened by exposures to various environmental contaminants, including air pollution. Some air pollutants have carcinogenic properties that are particularly problematic in South Carolina (SC), a state that consistently has high rates of cancer mortality for all sites. The purpose of this study was to assess cancer risk disparities in SC by linking risk estimates from the U.S. Environmental Protection Agency's 2005 National Air Toxics Assessment (NATA) with sociodemographic data from the 2000 US Census Bureau. Specifically, NATA risk data for varying risk categories were linked by tract ID and analyzed with sociodemographic variables from the 2000 census using R. The average change in cancer risk from all sources by sociodemographic variable was quantified using multiple linear regression models. Spatial methods were further employed using ArcGIS 10 to assess the distribution of all source risk and percent non-white at each census tract level. The relative risk (RR) estimates of the proportion of high cancer risk tracts (defined as the top 10% of cancer risk in SC) and their respective 95% confidence intervals (CIs) were calculated between the first and latter three quartiles defined by sociodemographic factors, while the variance in the percentage of high cancer risk between quartile groups was tested using Pearson's chi-square. The average total cancer risk for SC was 26.8 people/million (ppl/million). The risk from on-road sources was approximately 5.8ppl/million, higher than the risk from major, area, and non-road sources (1.8, 2.6, and 1.3ppl/million), respectively. Based on our findings, addressing on-road sources may decrease the disproportionate cancer risk burden among low-income populations and communities of color in SC.
ABSTRACT Background: The purpose of this study was to assess cancer risk disparities in SC using ... more ABSTRACT Background: The purpose of this study was to assess cancer risk disparities in SC using the USEPA's National Air Toxics Assessment (NATA) data and additional indicators such as sociodemographic characteristics from the 2000 US Census Bureau and Segregation (including Dissimilarity and Isolation Indices), Townsend, and Diversity Index. Methods: NATA risk data for varying risk categories were linked with 2000 census data and analyzed using R. Simple linear regression between indices or sociodemographic variables and cancer risk were used to quantify relationships while controlling for urban-rural effects. Percent high cancer risk tracts (cancer risk > 90th percentile of all tracts) were calculated in each quartile for every index and sociodemographic variable. Relative risk and 95% confidence intervals (CI) were estimated by comparing the first quartile with the latter three quartiles. The level of significance for differences in the percent high cancer risk between the first and latter quartiles was calculated for major, area, on-road, and non-road source cancer risk. Results: The cancer risk for 95% of tracts was 42/million which is lower than the national average (50/million). Cancer risk from on-road sources greatly contributed to all source risk when excluding background sources. There were no significant differences in percent high major source cancer risk within different quartiles of all indices; however, area cancer risk was higher in areas with a higher Isolation Index. When considering the urban-rural effect impacts, all of the coefficients were significant which means that the influence of both indices and sociodemographic status on cancer risk was different in urban and rural areas. The adjusted R-square (0.47) of the Isolation Index and percent urban area was the highest among all indices and sociodemographic variables. Conclusion: On-road sources and Isolation Index may be the best indicators of cancer risk and should be considered when addressing cancer disparities in SC.
ABSTRACT Purpose: Photovoice, documentary photography, was used as a participatory research metho... more ABSTRACT Purpose: Photovoice, documentary photography, was used as a participatory research method to document perceptions of local environmental hazards, pollution sources, and potential impact on health among community members to inform action steps to address environmental health disparities. Methods: A convenience sample of 16 adults (81% female) in Orangeburg County, South Carolina, a predominantly minority, underserved area with disparate health outcomes, was recruited and participated in a three-part implementation of photovoice. Participants completed a descriptive survey, received instructions, and took photos over specified period; selected and provided written descriptions for up to 10 photos; and engaged in a discussion after photo selection. Descriptive statistics were calculated for survey data. Photos and descriptions were reviewed using an iterative process involving participants, community leaders, and research team members. Results: Photos depicted positive and negative implications of the environment and health across seven emergent themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive photos (e.g., fresh fruits and vegetables, community gardens) and negative photos (e.g., standing water, abandoned houses) demonstrated a high level of interest among community members in considering how the environment influences health and contributes to health disparities. Evaluation of photos resulted in preparation of an action plan to guide future advocacy to support positive elements of the environment and address negative ones. Conclusions: Photovoice was successful in engaging participants in a thoughtful, strategic process of considering how the environment influences health and connects to health disparities. Participants were able to make connections that underscored the importance of environmental justice work in underserved communities. The next steps will include enactment of an action plan to sustain engagement and stimulate positive change to the environment to improve health in Orangeburg County.
ABSTRACT Purpose: To assess perceptions of local environmental hazards, pollution sources, and po... more ABSTRACT Purpose: To assess perceptions of local environmental hazards, pollution sources, and potential impact on health among residents to inform action steps to address environmental health disparities. Methods: A non-probability sample of residents of Orangeburg County, South Carolina, a predominantly minority, underserved area with disparate health outcomes, completed a cross-sectional, 58-item environmental health survey in paper-and-pen format or online from June-December 2013. The survey included items on family history of disease, knowledge of cancer information and environmental justice issues, perception of local environmental quality, perceived cancer risks, and descriptive items. Data were analyzed to calculate descriptive statistics and examine relationships. Results: Respondents (n=190) were predominantly African American, female, and had lived in the county for >10 years. Overall knowledge of cancer information and environmental justice issues were low to moderate. Sources of pollution, soil contamination, and toxic waste exposure were reported as being “very serious” health threats and problems in their community. Environmental conditions were viewed “very important” by most respondents. Perceptions of cancer risk on a community-level were high (e.g., environment plays a major role in causing cancer) but less so on an individual-level (e.g., low levels of perceived risk). Conclusion: Respondents indicated a high level of concern about the role of environmental determinants in their community and their health and exhibited low levels of perceived risk as individuals. The results underscore opportunity for community-engaged interventions to focus on the importance of individual, protective behavior but also action to address community-level environmental risks to address health disparities.
Environmental Health, 2013
International Journal of Environmental Research and Public Health, 2014
Journal of Community Health, 2014
Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and ... more Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and environmental factors, which in turn shape health decision-making. A paucity of studies has explored risk perceptions and worry in metropolitan areas with disparate environmental conditions and cancer outcomes. This study examined perceptions of cancer risk, neighborhood environmental health risks, and risk-reducing health behaviors among Blacks. A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina from March to September 2013. A convenience sample of males and females was recruited at local venues and community events. Descriptive statistics, bivariate analyses (Chi square tests), and logistic regression models were estimated using SAS 9.3 software. Respondents (N = 405) were 100 % Black, 81 % female (n = 323), and ranged from 18 to 87 years of age (M = 49.55, SD = 15.27). Most respondents reported lower perceptions of cancer risk (37 %) and equated their cancer beliefs to direct or indirect (i.e. personal or family) experiences. Low perceived cancer risk (absolute risk) was significantly associated (p < .05) with non-alcohol consumption, having a colon cancer screening test, being female, and being age 25-44 or 45-64. Cancer worry was significantly associated (p < .05) with being a current smoker, having a "fair" diet, non-alcohol consumption, and having any colon cancer screening test. Perceived cancer risk is an important indicator of health behaviors among Blacks. Direct or indirect experiences with cancer and/or the environment and awareness of family history of cancer may explain cancer risk perceptions.
Environmental Justice, 2013
There are approximately 590,000 underground storage tanks (USTs) nationwide that store petroleum ... more There are approximately 590,000 underground storage tanks (USTs) nationwide that store petroleum or hazardous substances. Many of these tanks are leaking, which may increase the risk of exposure to contaminants that promote health problems in host neighborhoods. Within this study, we assessed disparities in the spatial distribution of leaking underground storage tanks (LUSTs) based on socioeconomic status (SES) and race/ethnicity in South Carolina (SC). Chi-square tests were used to evaluate the difference in the proportion of populations who host a LUST compared to those not hosting a LUST for all sociodemographic factors. Linear regression models were applied to examine the association of distance to the nearest LUST with relevant sociodemographic measures. As percent black increased, the distance (both in kilometers and miles) to the nearest LUST decreased. Similar results were observed for percent poverty, unemployment, persons with less than a high school education, blacks in poverty, and whites in poverty. Furthermore, chi-square tests indicated that blacks or non-whites or people with low SES were more likely to live in LUST host areas than in non-host areas. As buffer distance increased, percent black and non-white decreased. SES variables demonstrated a similar inverse relationship. Overall, burden disparities exist in the distribution of LUSTs based on race/ethnicity and SES in SC.
Environmental Justice, 2012
Environmental Justice, 2011
American Journal of Public Health, 2012
Purpose: The purpose of this study was to explore community perceptions of cancer risk, environme... more Purpose: The purpose of this study was to explore community perceptions of cancer risk, environmental hazards, and health behaviors in an at-risk population. Methods: A convenience sample of residents in Metropolitan Charleston, South Carolina was recruited at local venues and community events to complete a 59-item health survey. Survey questions explored 6 domains: sociodemographic characteristics, environmental health risks, perceived cancer risk, health behaviors, self-efficacy, and social support which were adapted from existing surveys. Paper and online surveys were distributed from March to September 2013. SAS 9.3 was used to perform descriptive statistics. Results: Survey respondents (N=405) were 81% female (n=322) and 19% male (n=75), employed (60%), owned their home (60%), were college graduates (52%) with an annual household income of $20,000-49,999 and 18-87 years of age. Overall, respondents were non-smokers (88%), considered themselves to be overweight (59%), engaged in...
Research exploring the effects of travel for healthcare services are growing rapidly, particularl... more Research exploring the effects of travel for healthcare services are growing rapidly, particularly as GIS becomes more used by public health professionals. Mixed method explorations on the effects of travel impediments among patients suffering from rheumatic diseases have been very limited, however. Research has consistently indicated a shortage in rheumatologists, resulting in patients potentially having to travel long distances for care. Rheumatic diseases can cause extreme joint discomfort, making travelling long distances difficult; thus, more research exploring travel burden among patients suffering from rheumatic diseases is warranted. In this study, we conducted in-depth interviews with patients suffering from systemic lupus erythematous (SLE) as a pilot study, Ten (10) interviews were conducted among participants in the Medical University of South Carolina's SLE database. Grounding our research are two theoretical frameworks, both intersectionality and situational analys...
Studies have demonstrated an association between chronic illnesses and exposure to toxic environm... more Studies have demonstrated an association between chronic illnesses and exposure to toxic environmental conditions. We used Photovoice to document community members' perceptions of environmental factors that influence health and contribute to health disparities. We conducted a formative assessment of community risks to inform the development of an environmental health survey on cancer and environmental risk perceptions. Homogenous and convenience sampling were used to recruit community members (n=14) across North Charleston, South Carolina. Participants documented positive and negative environmental features of their neighborhoods using Photovoice. Group consensus was employed to identify and confirm photo themes. Research staff identified 10 emergent themes from the photos. They included: housing/dwellings, industrial, hazards/pollution, beautification, places of worship, human and social services, businesses/schools, construction, natural environment, and other. Photovoice resu...
Purpose: To describe the process evaluation of a pilot Summer Enrichment program (SEP) at the Uni... more Purpose: To describe the process evaluation of a pilot Summer Enrichment program (SEP) at the University of South Carolina that provided opportunities and experiences for underrepresented undergraduate students to gain exposure to research careers in environmental health sciences and environmental justice. The project also provided graduate students from the University valuable practice in program planning, implementation and evaluation. Methods: Qualitative data collection methods were used to conduct a process evaluation of this pilot project, primarily from the perspective of the undergraduate students who participated and the graduate students who planned and implemented the program. Data were collected using two methods, weekly journals and open-ended surveys, which measured the usefulness of program experiences to career intentions and the feasibility of such a project. Results: The results indicated that the SEP provided both undergraduate and graduate level students the oppo...
Purpose: A considerable body of environmental justice (EJ) research finds that neighborhoods with... more Purpose: A considerable body of environmental justice (EJ) research finds that neighborhoods with lower environmental quality may be overrepresented by ethnic minorities and economically disadvantaged populations. The quality of the physical environment is one of the factors that contribute to high levels of community stress and leads to disparities in health. We assessed the physical and social features that contribute to poor health. Methods: We trained 10 community leaders and stakeholders to conduct community block assessments (CBA) identifying physical and social features and categorizing and mapping non-residential characteristics in their neighborhoods. A structured assessment tool was adapted from the Johns Hopkins Neighborhood Inventory for Environmental Typology (NiFeTy) and modified to best suit the rural nature of North Charleston. A total of 62 blocks in four target communities were assessed and compared to each other on salutogenic and pathogenic features. Results: Com...
American journal of men's health, Jan 3, 2015
Since prostate cancer continues to disproportionately affect African American men in terms of inc... more Since prostate cancer continues to disproportionately affect African American men in terms of incidence, morbidity, and mortality, prostate-specific antigen (PSA) screening plays an important role in early detection, especially when men engage in informed decision making to accept or decline this test. The authors evaluated utilization of PSA testing among African American men based on factors that are important components of making informed decisions. Utilization of PSA testing was evaluated based on whether men had ever had PSA testing and PSA testing during the past year in a community-based sample of African American men ages 50 to 75 (n = 132). Overall, 64% of men (n = 85) reported that they had ever had a PSA test; the mean (SD) age for first use of PSA testing was 47.7 (SD = 7.4). The likelihood of ever having a PSA test increased significantly with physician communication (odds ratio [OR] = 14.2; 95% confidence interval [CI] = 4.20, 48.10; p = .0001) and with having an annua...
Background: Disadvantaged and low-income populations bear an unequal burden of air toxics exposur... more Background: Disadvantaged and low-income populations bear an unequal burden of air toxics exposure and risk due to the spatial distribution of environmental contaminants. Objectives: The purpose of this study was to assess the relative contribution of various pollution sources to cancer risk across socioeconomic and racial characteristics in Metropolitan Charleston, South Carolina. Methods: Cancer risk estimates were extracted from the National-Scale Air Toxics Assessment and linked with 2000 Census tract data. Data linking and statistical analyses were performed in R. Maps were developed in ArcGIS version 10. Relative risk and 95% confidence intervals of elevated risk were calculated across exposure source and quartiles of socioeconomic and racial characteristics. Chi-square tests were used to test the variance in the percentage of high cancer risk between quartiles. Results: Background and on-road source risk were significantly higher than risks from other sources. Percent non-whi...
Background: Studies have demonstrated an association between perceptions and environmental health... more Background: Studies have demonstrated an association between perceptions and environmental health risk and cancer risk separately, but a paucity of research has explored perceptions as a concurrent contributor of health disparities in at-risk populations. We explored the relationship between perceived cancer (PCR) and socioeconomic factors, neighborhood environment, and risk-reducing health behaviors. Methods: A 59-item community environmental health survey was administered in Metropolitan Charleston (Berkeley, Charleston, and Dorchester Counties) from March 2013 to September 2013. A convenience sample of 405 adults was recruited at local venues (e.g., libraries, housing authority, and hair salons) and community events. Multivariate logistic regressions were performed in SAS 9.3. Results: Respondents (N=405) were 99% African American, 81% female (n=322), 19% male (n=75), and ranged from 18 to 87 years of age. Low PCR when measured by likelihood of cancer was associated with non-alco...
Cancer Epidemiology Biomarkers & Prevention, 2014
Environmental Research, 2015
Populations of color and low-income communities are often disproportionately burdened by exposure... more Populations of color and low-income communities are often disproportionately burdened by exposures to various environmental contaminants, including air pollution. Some air pollutants have carcinogenic properties that are particularly problematic in South Carolina (SC), a state that consistently has high rates of cancer mortality for all sites. The purpose of this study was to assess cancer risk disparities in SC by linking risk estimates from the U.S. Environmental Protection Agency's 2005 National Air Toxics Assessment (NATA) with sociodemographic data from the 2000 US Census Bureau. Specifically, NATA risk data for varying risk categories were linked by tract ID and analyzed with sociodemographic variables from the 2000 census using R. The average change in cancer risk from all sources by sociodemographic variable was quantified using multiple linear regression models. Spatial methods were further employed using ArcGIS 10 to assess the distribution of all source risk and percent non-white at each census tract level. The relative risk (RR) estimates of the proportion of high cancer risk tracts (defined as the top 10% of cancer risk in SC) and their respective 95% confidence intervals (CIs) were calculated between the first and latter three quartiles defined by sociodemographic factors, while the variance in the percentage of high cancer risk between quartile groups was tested using Pearson's chi-square. The average total cancer risk for SC was 26.8 people/million (ppl/million). The risk from on-road sources was approximately 5.8ppl/million, higher than the risk from major, area, and non-road sources (1.8, 2.6, and 1.3ppl/million), respectively. Based on our findings, addressing on-road sources may decrease the disproportionate cancer risk burden among low-income populations and communities of color in SC.
ABSTRACT Background: The purpose of this study was to assess cancer risk disparities in SC using ... more ABSTRACT Background: The purpose of this study was to assess cancer risk disparities in SC using the USEPA's National Air Toxics Assessment (NATA) data and additional indicators such as sociodemographic characteristics from the 2000 US Census Bureau and Segregation (including Dissimilarity and Isolation Indices), Townsend, and Diversity Index. Methods: NATA risk data for varying risk categories were linked with 2000 census data and analyzed using R. Simple linear regression between indices or sociodemographic variables and cancer risk were used to quantify relationships while controlling for urban-rural effects. Percent high cancer risk tracts (cancer risk > 90th percentile of all tracts) were calculated in each quartile for every index and sociodemographic variable. Relative risk and 95% confidence intervals (CI) were estimated by comparing the first quartile with the latter three quartiles. The level of significance for differences in the percent high cancer risk between the first and latter quartiles was calculated for major, area, on-road, and non-road source cancer risk. Results: The cancer risk for 95% of tracts was 42/million which is lower than the national average (50/million). Cancer risk from on-road sources greatly contributed to all source risk when excluding background sources. There were no significant differences in percent high major source cancer risk within different quartiles of all indices; however, area cancer risk was higher in areas with a higher Isolation Index. When considering the urban-rural effect impacts, all of the coefficients were significant which means that the influence of both indices and sociodemographic status on cancer risk was different in urban and rural areas. The adjusted R-square (0.47) of the Isolation Index and percent urban area was the highest among all indices and sociodemographic variables. Conclusion: On-road sources and Isolation Index may be the best indicators of cancer risk and should be considered when addressing cancer disparities in SC.
ABSTRACT Purpose: Photovoice, documentary photography, was used as a participatory research metho... more ABSTRACT Purpose: Photovoice, documentary photography, was used as a participatory research method to document perceptions of local environmental hazards, pollution sources, and potential impact on health among community members to inform action steps to address environmental health disparities. Methods: A convenience sample of 16 adults (81% female) in Orangeburg County, South Carolina, a predominantly minority, underserved area with disparate health outcomes, was recruited and participated in a three-part implementation of photovoice. Participants completed a descriptive survey, received instructions, and took photos over specified period; selected and provided written descriptions for up to 10 photos; and engaged in a discussion after photo selection. Descriptive statistics were calculated for survey data. Photos and descriptions were reviewed using an iterative process involving participants, community leaders, and research team members. Results: Photos depicted positive and negative implications of the environment and health across seven emergent themes: recreation and leisure; food access; hazards and pollution; health, human, and social services; economic issues; beautification; and accommodation and accessibility. Positive photos (e.g., fresh fruits and vegetables, community gardens) and negative photos (e.g., standing water, abandoned houses) demonstrated a high level of interest among community members in considering how the environment influences health and contributes to health disparities. Evaluation of photos resulted in preparation of an action plan to guide future advocacy to support positive elements of the environment and address negative ones. Conclusions: Photovoice was successful in engaging participants in a thoughtful, strategic process of considering how the environment influences health and connects to health disparities. Participants were able to make connections that underscored the importance of environmental justice work in underserved communities. The next steps will include enactment of an action plan to sustain engagement and stimulate positive change to the environment to improve health in Orangeburg County.
ABSTRACT Purpose: To assess perceptions of local environmental hazards, pollution sources, and po... more ABSTRACT Purpose: To assess perceptions of local environmental hazards, pollution sources, and potential impact on health among residents to inform action steps to address environmental health disparities. Methods: A non-probability sample of residents of Orangeburg County, South Carolina, a predominantly minority, underserved area with disparate health outcomes, completed a cross-sectional, 58-item environmental health survey in paper-and-pen format or online from June-December 2013. The survey included items on family history of disease, knowledge of cancer information and environmental justice issues, perception of local environmental quality, perceived cancer risks, and descriptive items. Data were analyzed to calculate descriptive statistics and examine relationships. Results: Respondents (n=190) were predominantly African American, female, and had lived in the county for >10 years. Overall knowledge of cancer information and environmental justice issues were low to moderate. Sources of pollution, soil contamination, and toxic waste exposure were reported as being “very serious” health threats and problems in their community. Environmental conditions were viewed “very important” by most respondents. Perceptions of cancer risk on a community-level were high (e.g., environment plays a major role in causing cancer) but less so on an individual-level (e.g., low levels of perceived risk). Conclusion: Respondents indicated a high level of concern about the role of environmental determinants in their community and their health and exhibited low levels of perceived risk as individuals. The results underscore opportunity for community-engaged interventions to focus on the importance of individual, protective behavior but also action to address community-level environmental risks to address health disparities.
Environmental Health, 2013
International Journal of Environmental Research and Public Health, 2014
Journal of Community Health, 2014
Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and ... more Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and environmental factors, which in turn shape health decision-making. A paucity of studies has explored risk perceptions and worry in metropolitan areas with disparate environmental conditions and cancer outcomes. This study examined perceptions of cancer risk, neighborhood environmental health risks, and risk-reducing health behaviors among Blacks. A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina from March to September 2013. A convenience sample of males and females was recruited at local venues and community events. Descriptive statistics, bivariate analyses (Chi square tests), and logistic regression models were estimated using SAS 9.3 software. Respondents (N = 405) were 100 % Black, 81 % female (n = 323), and ranged from 18 to 87 years of age (M = 49.55, SD = 15.27). Most respondents reported lower perceptions of cancer risk (37 %) and equated their cancer beliefs to direct or indirect (i.e. personal or family) experiences. Low perceived cancer risk (absolute risk) was significantly associated (p < .05) with non-alcohol consumption, having a colon cancer screening test, being female, and being age 25-44 or 45-64. Cancer worry was significantly associated (p < .05) with being a current smoker, having a "fair" diet, non-alcohol consumption, and having any colon cancer screening test. Perceived cancer risk is an important indicator of health behaviors among Blacks. Direct or indirect experiences with cancer and/or the environment and awareness of family history of cancer may explain cancer risk perceptions.
Environmental Justice, 2013
There are approximately 590,000 underground storage tanks (USTs) nationwide that store petroleum ... more There are approximately 590,000 underground storage tanks (USTs) nationwide that store petroleum or hazardous substances. Many of these tanks are leaking, which may increase the risk of exposure to contaminants that promote health problems in host neighborhoods. Within this study, we assessed disparities in the spatial distribution of leaking underground storage tanks (LUSTs) based on socioeconomic status (SES) and race/ethnicity in South Carolina (SC). Chi-square tests were used to evaluate the difference in the proportion of populations who host a LUST compared to those not hosting a LUST for all sociodemographic factors. Linear regression models were applied to examine the association of distance to the nearest LUST with relevant sociodemographic measures. As percent black increased, the distance (both in kilometers and miles) to the nearest LUST decreased. Similar results were observed for percent poverty, unemployment, persons with less than a high school education, blacks in poverty, and whites in poverty. Furthermore, chi-square tests indicated that blacks or non-whites or people with low SES were more likely to live in LUST host areas than in non-host areas. As buffer distance increased, percent black and non-white decreased. SES variables demonstrated a similar inverse relationship. Overall, burden disparities exist in the distribution of LUSTs based on race/ethnicity and SES in SC.
Environmental Justice, 2012
Environmental Justice, 2011
American Journal of Public Health, 2012