Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet

Objective: The San Joaquin Valley (SJV) exceeds the state and national standards for ozone (O₃). This study investigates whether short-term exposure to O₃ is associated with asthma emergency department (ED) visits. Methods: We identified 1,101 ED visits in June–September of 2015 in SJV, California, who lived within 15 km of active air monitors. Conditional logistic regression models were used to obtain the odds ratio (OR) and 95% confidence interval (CI) associated with an interquartile (IQR) increase in ozone. We explored the potential effect modification by sex (female and male), race (White, Black and Hispanic), age (2–5, 6–18, 19–40, 41–64 and > = 65) and county (Merced, Madera, Kings, Fresno and Kern). Results: An IQR range (18.1 ppb) increase in O₃ exposure three days before an asthma attack (lag 3) was associated with a 6.6% [OR: 1.066 (95% CI: 1.032, 1.082)] increase in the odds of having an asthma ED visit. The overall ORs differed across age groups and races/ethnicities, with strongest for children aged 6–18 years [OR: 1.219 (95% CI: 1.159, 1.280)], adults 19–40 years [OR: 1.102 (95% CI: 1.053, 1.154)] and Blacks [OR: 1.159 (95% CI: 1.088, 1.236)], respectively. O₃ exposure was not positively associated with asthma ED visits for Whites, while it was for other underrepresented groups. Fresno had the highest number of asthma ED visits and positive association among all five counties. Conclusion: We found that O₃ exposure is associated with asthma ED visits in the SJV.

To determine if cigarette smoking, electronic cigarette use, and rate of consumption of these products differed before and after a pandemic lockdown order, two convenience samples of adults in Central California were recruited and surveyed before (March 2020) and after (May 2020) COVID-19 lockdown orders were implemented in California (n = 2571). Multivariable logistic and negative binomial regression models tested the association between adults recruited pre- or post-California lockdown and past month cigarette use, past month electronic cigarette use, past month cigarette consumption, and past month e-cigarette consumption among current users, controlling for demographic differences. Adults pre- and post-lockdown had equal odds of using cigarettes during the past month. Cigarette users who responded post-lockdown had higher cigarette consumption rates compared to cigarette users who responded pre-lockdown (IRR = 1.13, 95% CI = 1.15, 1.23). Adults who responded post-lockdown had lower odds of using electronic cigarettes during the past month compared to participants surveyed before the order (OR = 0.66, 95% CI: 0.55, 0.78). Cigarette users may be using more cigarettes during the state mandated lockdown. Possible causes for this increase in cigarette use may include increased stress, the change in workplace smokefree protections coverage, and increased opportunities for smoking or vaping.

The CalEnviroScreen created by the Office of Environmental Health Hazard Assessment, Sacramento, USA, is a place-based dataset developed to measure environmental and social indicators that are theorized to have cumulative health impacts on populations. The objective of this study was to examine the extent to which the composite scores of the CalEnviroScreen tool are associated with pediatric asthma hospitalization. This was a retrospective analysis of California hospital discharge data from 2010 to 2012. Children who were hospitalized for asthma-related conditions, were aged 0–14 years, and resided in California were included in analysis. Rates of hospitalization for asthma-related conditions among children residing in California were calculated. Poisson multilevel modeling was used to account for individual- and neighborhood-level risk factors. Every unit increase in the CalEnviroScreen Score was associated with an increase of 1.6% above the mean rate of pediatric asthma hospitalizations (rate ratio (RR) = 1.016, 95% confidence interval (CI) = 1.014–1.018). Every unit increase in racial/ethnic segregation and diesel particulate matter was associated with an increase of 1.1% and 0.2% above the mean rate of pediatric asthma, respectively (RR = 1.011, 95% CI = 1.010–1.013; RR = 1.002, 95% CI = 1.001–1.004). The CalEnviroScreen is a unique tool that combines socioecological factors and environmental indicators to identify vulnerable communities with major health disparities, including pediatric asthma hospital use. Future research should identify mediating factors that contribute to community-level health disparities.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: There are significant health technology gaps between Latinos and NH Whites, and between first and second generation Latinos. Objective: The purpose of this study is to examine disparities in online health information seeking behavior (HISB) and health information technology (HIT) use among Latinos, taking into account nativity and sub-ethnic affiliation. Methods: We analyzed US-born, non-Hispanic (NH) Whites and Latinos adults (N=49,259) in the 2015-16 National Health Interview Survey using a binary logistic regression controlling for individual difference level variables. Outcomes were Internet use, HISB (online health information-seeking and using a chat group for health information), and HIT (using a computer to schedule an appointment, filling a prescription, communicating with a provider). Results: We found that US-born Mexicans (OR=0.83, 95% CI: 0.70, 0.99), US-born Central/South Americans (OR=2.11, 95% CI: 1.11, 3.99), foreign-born Mexicans (OR=0.31, 95% CI: 0.26, 0.37), Foreign-born Puerto Ricans (OR=0.57, 95% CI: 0.43, 0.76), foreign-born Central/South Americans (OR=0.37, 95% CI: 0.29, 0.47), and foreign-born Other Latinos (OR= 0.33, 95% CI: 0.23, 0.48) had lower odds of using the Internet than US-born NH Whites. The relationship between subgroup affiliation and online health information seeking behavior varied by type of technology. US-born Mexicans (OR=0.76, 95%CI: 0.67, 0.87), foreign-born Mexicans (OR=0.38, 95% CI: 0.32, 0.44), foreign-born Puerto Ricans (OR=0.65, 95% CI: 0.49, 0.86), foreign-born Central/South Americans (OR=0.43, 95% CI: 0.35, 0.52) and foreign-born Other Latinos (OR=0.36, 95% CI: 0.27, 0.47) had lower odds of looking up health information online than US-born NH Whites. Controlling for age, sex, education, income to federal poverty level, and region foreign-born Mexicans (OR=0.48, 95% CI: 0.35, 0.67), foreign-born Central/South American (OR=0.53, 95% CI: 0.35, 0.80), and foreign-born Other Latino (OR=0.18, 95% CI: 0.08, 0.43) had lower odds of filling a prescription using a computer than US-born NH Whites. Foreign-born Mexicans (OR=0.57, 95% CI: 0.43, 0.75), foreign-born Central/South American (OR=0.68, 95% CI: 0.50, 0.94), and foreign-born Other Latino (OR=0.39, 95% CI: 0.23, 0.69) had lower odds of using a computer to schedule medical appointments than US-born NH Whites, while there was no significant relationship for other groups. US-born Mexicans (OR=0.81, 95% CI: 0.65, 1.00), US-born Other Latinos (OR=0.44, 95% CI: 0.21, 0.92), foreign-born Mexicans (OR=0.34, 95% CI: 0.24, 0.48), foreign-born Puerto Ricans (OR=0.47, 95% CI: 0.27, 0.81), foreign-born Central/South Americans (OR=0.58, 95% CI: 0.42, 0.83), and foreign-born Other Latinos (OR=0.36, 95% CI: 0.18, 0.72) have lower odds of emailing a healthcare provider than US-born NH Whites. Conclusions: We found Latino subgroups do not use health information channels equally, and attempts to target Latinos should take ethnicity and nativity into account. Clinical Trial: n/a

Background: Lack of access to adequate, safe, and nutritious food is a major concern for the Afghan population due to ongoing war and humanitarian crises. Recently resettled Afghan refugees in the US continue to face challenges securing adequate, nutritious food resources in new environments. This study examined Afghan refugees’ food access and insecurity in the San Joaquin Valley, California. Methods: Semi-structured, in-depth interviews were conducted to collect the perspectives and experiences of key informants and newly arrived Afghan refugees. Results: This study highlights environmental and structural factors (availability and accessibility of grocery stores; availability of religious-appropriate items in the stores; the public benefit received by a family; and public transportation) and individual factors (religious and cultural practices; financial and language barriers) as major determinants of post-resettlement food insecurity. Conclusion: Increasing the accessibility and affordability of culturally and religiously appropriate food items within the US food system, enhancing the collaboration of community volunteers and resettlement organizations in the direct assistance of new families, and providing continuous access to public benefits are possible steps to mitigate the risk of food insecurity among Afghan refugees. This study suggests a continuous examination of the degree of food insecurity in this population and its attendant health impacts.