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Chaix, B, Duncan D, Vallee J, Vernez-Moudon A, Benmarhnia T, Kestens Y.  2017.  The "Residential" Effect Fallacy in Neighborhood and Health Studies Formal Definition, Empirical Identification, and Correction. Epidemiology. 28:789-797.   10.1097/ede.0000000000000726   AbstractWebsite

Background: Because of confounding from the urban/rural and socioeconomic organizations of territories and resulting correlation between residential and nonresidential exposures, classically estimated residential neighborhood-outcome associations capture nonresidential environment effects, overestimating residential intervention effects. Our study diagnosed and corrected this "residential" effect fallacy bias applicable to a large fraction of neighborhood and health studies. Methods: Our empirical application investigated the effect that hypothetical interventions raising the residential number of services would have on the probability that a trip is walked. Using global positioning systems tracking and mobility surveys over 7 days (227 participants and 7440 trips), we employed a multilevel linear probability model to estimate the trip-level association between residential number of services and walking to derive a naive intervention effect estimate and a corrected model accounting for numbers of services at the residence, trip origin, and trip destination to determine a corrected intervention effect estimate (true effect conditional on assumptions). Results: There was a strong correlation in service densities between the residential neighborhood and nonresidential places. From the naive model, hypothetical interventions raising the residential number of services to 200, 500, and 1000 were associated with an increase by 0.020, 0.055, and 0.109 of the probability of walking in the intervention groups. Corrected estimates were of 0.007, 0.019, and 0.039. Thus, naive estimates were overestimated by multiplicative factors of 3.0, 2.9, and 2.8. Conclusions: Commonly estimated residential intervention-outcome associations substantially overestimate true effects. Our somewhat paradoxical conclusion is that to estimate residential effects, investigators critically need information on nonresidential places visited.

Benmarhnia, T, Huang J, Basu R, Wu J, Bruckner TA.  2017.  Decomposition analysis of black-white disparities in birth outcomes: The relative contribution of air pollution and social factors in California. Environmental Health Perspectives. 125   10.1289/ehp490   AbstractWebsite

BACKGROUND: Racial/ethnic disparities in preterm birth (PTB) are well documented in the epidemiological literature, but little is known about the relative contribution of different social and environmental determinants of such disparities in birth outcome. Furthermore, increased focus has recently turned toward modifiable aspects of the environment, including physical characteristics, such as neighborhood air pollution, to reduce disparities in birth outcomes. OBJECTIVES: To apply decomposition methods to understand disparities in preterm birth (PTB) prevalence between births of non-Hispanic black individuals and births of non-Hispanic white individuals in California, according to individual demographics, neighborhood socioeconomic environment, and neighborhood air pollution. METHODS: We used all live singleton births in California spanning 2005 to 2010 and estimated PTBs and other adverse birth outcomes for infants borne by non-Hispanic black mothers and white mothers. To compare individual-level, neighborhood-level, and air pollution [Particulate. Matter, 2.5 micrometers or less (PM2.5) and nitrogen dioxide (NO2)] predictors, we conducted a nonlinear extension of the. Blinder-Oaxaca method to decompose racial/ethnic disparities in PTB. RESULTS: The predicted differences in probability of PTB between black and white infants was 0.056 (95% CI: 0.054, 0.058). All included predictors explained 37.8% of the black-white disparity. Overall, individual (17.5% for PTB) and neighborhood-level variables (16.1% for PTB) explained a greater proportion of the black-white difference in birth outcomes than air pollution (5.7% for PTB). CONCLUSIONS: Our results suggest that, although the role of individual and neighborhood factors remains prevailing in explaining black-white differences in birth outcomes, the individual contribution of PM2.5 is comparable in magnitude to any single individual- or neighborhood-level factor.

Deguen, S, Petit C, Delbarre A, Kihal W, Padilla C, Benmarhnia T, Lapostolle A, Chauvin P, Zmirou-Navier D.  2015.  Neighbourhood characteristics and long-term air pollution levels modify the association between the short-term nitrogen dioxide concentrations and all-cause mortality in Paris. Plos One. 10   ARTN e013146310.1371/journal.pone.0131463   AbstractWebsite

BackgroundWhile a great number of papers have been published on the short-term effects of air pollution on mortality, few have tried to assess whether this association varies according to the neighbourhood socioeconomic level and long-term ambient air concentrations measured at the place of residence. We explored the effect modification of 1) socioeconomic status, 2) long-term NO2 ambient air concentrations, and 3) both combined, on the association between short-term exposure to NO2 and all-cause mortality in Paris (France).MethodsA time-stratified case-crossover analysis was performed to evaluate the effect of short-term NO2 variations on mortality, based on 79,107 deaths having occurred among subjects aged over 35 years, from 2004 to 2009, in the city of Paris. Simple and double interactions were statistically tested in order to analyse effect modification by neighbourhood characteristics on the association between mortality and short-term NO2 exposure. The data was estimated at the census block scale (n=866).ResultsThe mean of the NO2 concentrations during the five days prior to deaths were associated with an increased risk of all-cause mortality: overall Excess Risk (ER) was 0.94% (95% CI=[0.08;1.80]. A higher risk was revealed for subjects living in the most deprived census blocks in comparison with higher socioeconomic level areas (ER=3.14% (95% CI=[1.4-14.90], p<0.001). Among these deprived census blocks, excess risk was even higher where long-term average NO2 concentrations were above 55.8 mu g/m(3) (the top tercile of distribution): ER=4.84%(95% CI=[1.56;8.24], p for interaction= 0.02).ConclusionOur results show that people living in census blocks characterized by low socioeconomic status are more vulnerable to air pollution episodes. There is also an indication that people living in these disadvantaged census blocks might experience even higher risk following short-term air pollution episodes, when they are also chronically exposed to higher NO2 levels.

Beck, F, Richard JB, Deutsch A, Benmarhnia T, Pirard P, Roudier C, Peretti-Watel P.  2013.  Knowledge about radon and its associated risk perception in France. Cancer Radiotherapie. 17:744-749.   10.1016/j.canrad.2013.06.044   AbstractWebsite

Purpose. - Radon exposure is a major environmental risk in health. It remains badly known by the general population. It is the second cause of lung cancer, after tobacco smoking. The aim of this cross-sectional general population survey was to describe radon exposure risk knowledge and the socioeconomic factors related to this knowledge.Materials and methods. - The Cancer Barometer survey 2010 questioned the French population about its knowledge of radon as such and as health risk factor. This survey was a two-stage random sampling with computer-assisted telephone interview that was performed from April 3, 2010 to August 7, 2010 on a sample of 3,359 people aged 15 to 75 years old.Results. - Among people aged 15 to 75 years old, only one in five knows that radon is a natural gas coming from the ground. This knowledge is more frequent among people living in an area that is directly concerned by radon, among men and increases with age, with the level of education and the level of income. Radon risk remains still widely underestimated by the general public, including in areas concerned by this risk. When people were confronted with radon exposure, few intended to remedy by improving their home.Conclusion. - The success of prevention initiatives implies the support and the collaboration of various national and local actors. To improve their impact for the prevention of lung cancers, it could be more effective to couple these actions with prevention messages on tobacco. (C) 2013 Societe francaise de radiotherapie oncologique (SFRO). Published by Elsevier Masson SAS. All rights reserved.