Our Latest Research and Publications

Antibiotics in corals of the South China Sea: Occurrence, distribution, bioaccumulation, and considerable role of coral mucus

Journal:  Environmental Pollution

Co-author:  An Li, PhD, Samuel and Catherine Epstein Professor of environmental and occupational health sciences.

Summary:  Manmade antibiotics are emerging organic pollutants widely detected in the marine environment. In this study, 14 out of 19 target antibiotics were detected in corals collected from coastal and offshore regions in the South China Sea. The average total antibiotic concentrations (Sigma(19)ABs) in the two regions were similar: 28 ng/g for coastal corals and 31 ng/g for offshore corals, based on dry tissue weight (dw). Fluoroquinolones (FQs) were predominant antibiotics in the coastal corals (mean Sigma FQs: 18 ng/g dw), while sulfonamides (SAs) predominated in the offshore corals (mean Sigma SAs: 23 ng/g dw). However, corals living in coastal regions tend to excrete more mucus than corals in offshore habitat. We found 53% by average of Sigma(19)ABs in the mucus of the coastal corals; while in offshore corals, most antibiotics (88% by average) were accumulated in the tissues. In addition, the tissue-mucus mass distribution differs among individual antibiotics. Sulfonamides were mainly accumulated in tissues while fluoroquinolones were present mainly in mucus. The results of this study suggest that mucus played an important role in the bioaccumulation of antibiotics by corals. It may resist the bioaccumulation of antibiotics by coral tissue, especially for the coastal corals. Additionally, corals were compared with other marine biotas in the study area and found to be more bioaccumulative towards antibiotics.

Applying Theory of Change to a Structural Change Initiative: Evaluation  of Model Communities in a Diverse County

Journal:  Health Education and Behavior

Co-authors:  Christina Welter, DrPH, clinical assistant professor of community health sciences and Yuka Asada, PhD in Maternal and Child Health ’15 and post doctoral research associate at the Institute for Health Research and Policy.

Summary:  Structural change approaches, also called policy, systems, and environmental change approaches, have been increasingly promoted and adopted by public ealth agencies in the past decade. These interventions require attention to multilevel, complex and contextual influences on individual and community health outcomes, requiring a sound theoretical framework that links the many processes and outcomes over time. The Model Communities program of Cook County, Illinois Communities Putting Prevention to Work program employed a theory of change (ToC) framework to inform the evaluations’ design and execution. The main objective of this study was to apply findings from the longitudinal multiple case study evaluation to develop an adapted ToC. We conducted 97 key informant interviews across three waves, with a focus on Model Communities program participants’, Communities Putting Prevention to Work staff, and technical assistance providers’ experiences over time. Four analysts organized and coded the data using qualitative software; exploratory functions and data matrices were employed throughout three waves of analysis. Adaptations to the ToC included the addition of a construct, “change readiness,” as well as refinements to constructs: organizational capacity (human capital, technical assistance, informal and formal leadership), local partnerships, and the importance of sustainability. The findings offer a data-informed theoretical framework that may be considered for use in evaluations of structural change interventions in complex and diverse counties.

Large urban center improves out-of-hospital cardiac arrest survival

Journal:  Resuscitation

Co-authors:  Hai Nguyen, PhD in Biostatistics student and research assistant at the Institute for Health Research and Policy and Oksana Pugach, MS in Biostatistics ’06, PhD in Biostatistics ’12 and biostatistician at the Institute for Health Research and Policy.

Summary:  Large cities pose unique challenges that limit the effectiveness of system improvement interventions. Successful implementation of integrated cardiac resuscitation systems of care can serve as a model for other urban centers.  This was a retrospective analysis of prospectively collected data of adult cases of non-traumatic cardiac arrest who received treatment by Chicago Fire Department EMS from September 1, 2013 through December 31, 2016. We measured temporal outcomes during implementation of system-wide initiatives including telephone-assisted and community CPR training programs; high performance CPR and team based simulation training; new post resuscitation care and destination protocols; and case review for EMS providers. Outcomes measured included bystander CPR rates, return of spontaneous circulation, hospital admission and survival, and favorable neurologic outcomes (CPC 1-2). Relative risk was determined by logistic regression model where observed group-specific outcomes are expressed as odds ratios.  The study found that densely populated cities with low survival rates can overcome systematic challenges and improve survival.

Comparative Effectiveness Trial of an Obesity Prevention Intervention in EFNEP and SNAP-ED: Primary Outcomes

Journal:  Nutrients

Co-authors:  Joanna Buscemi, post-doctoral fellow, Institute for Health Research and Policy; Michael Berbaum, director of the Methodology Research Core, Institute for Health Research and Policy; and Marian Fitzgibbon, deputy director, Institute for Health Research and Policy.

Summary:  There is a need to disseminate evidence-based childhood obesity prevention interventions on a broader scale to reduce obesity-related disparities among underserved children. The purpose of this study was to test the comparative effectiveness of an evidence-based obesity prevention intervention, Hip-Hop to Health (HH), delivered through Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) versus the standard curriculum delivered by the programs (Standard Nutrition Education (NE)). A nonequivalent control group design was delivered to compare the effectiveness of HH to NE on weight gain prevention and health behavior outcomes at EFNEP and SNAP-Ed sites. One hundred and fifty-three caregiver-child dyads (n = 103 in the HH group; n = 50 in the NE group) participated in the study. HH is an evidence-based dietary and physical activity intervention for low-income preschool children. The NE curriculum provided lessons for children that are consistent with the Dietary Guidelines for Americans 2010. Data were collected on demographics, anthropometrics, and behavioral variables for parent-child dyads at baseline and postintervention. Mixed model methods with random effects for site and participant were utilized. No differences in child or caregiver diet, physical activity, or screen time by group were found. No between-group differences in child BMI z-score were found; however, caregivers in the HH group lost significantly more weight than those in the NE group. Results from this trial can inform future dissemination efforts of evidenced-based programs for underserved families.

Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos

Journal:  Heart

Co-authors:  Victoria W. Persky, PhD, professor of epidemiology and Maria Argos, PhD, associate professor of epidemiology, among others.

Summary:  Objective Cardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers.

Cross-sectional data from 7404 employed individuals, aged 18-74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models.

Hispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures.

Our results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.

Sugar-sweetened beverage prices: Variations by beverage, food store, and neighborhood characteristics, 2017

Journal:  Preventive Medicine Reports

Co-authors:  Lisa Powell, PhD, professor of health policy and administration and Julien Leider, research specialist, Health Policy Center.

Summary:  Sugar-sweetened beverage (SSB) consumption is associated with obesity, type 2 diabetes, and cardiovascular disease. A number of U.S. jurisdictions have levied volume-based specific SSB taxes. This study estimated baseline mean SSB prices across categories and sizes as this will help to determine the percentage increase in price resulting from the imposition of specific taxes.

Data on food store SSB prices were collected in 2017 in Cook County, IL, St. Louis City/County, MO, Oakland, CA, and Sacramento, CA (N = 11,767 product-level observations from 581 stores). Data were weighted to represent volume sold by category and size. Mean prices per ounce were computed across categories and sizes. Linear regression models, clustered on store, were run to estimate associations between price per ounce and product characteristics, neighborhood (linked by census tract) characteristics, store type, and site.

Weighted summary statistics show that the mean price of SSBs was 4.8 cents/oz. Soda was least expensive (3.4 cents/oz), followed by sports drinks (4.8 cents/oz), juice drinks (5.2 cents/oz), ready-to-drink tea/coffee (7.8 cents/oz), and energy drinks (19.9 cents/oz). Prices were higher for individual-sized (9.6 cents/oz) compared to family-sized drinks (>1 L/multi-pack; 3.5 cents/oz). Regression results revealed that prices were lower in stores in majority non-Hispanic black tracts and varied by beverage characteristics and store type but not tract-level socioeconomic status.

Given substantial variation in prices by SSB category, a penny-per-ounce SSB tax, if fully passed through, would increase soda prices by 29% versus 5% for energy drinks, highlighting the potential importance of different specific tax rates across beverage categories.

An Assessment of Food Store Compliance With the Cook County Sweetened Beverage Tax

Journal:  Public Health Management and Practice

Co-authors:  Jamie Chriqui, PhD, professor of health policy and administration; Lisa Powell, PhD, professor of health policy and administration; Andrea Pipito, program manager, Institute for Health Research and Policy; and Julien Leider, research specialist, Health Policy Center.

Summary:  To examine the correct application of the $0.01/ounce Cook County, Illinois, Sweetened Beverage Tax on sugar-sweetened and artificially sweetened beverages, a total of 111 beverage products were purchased from 28 food stores in September and November 2017. Purchases were categorized by taxable (sugar-sweetened and artificially sweetened soda and juice drinks) and nontaxable (100% fruit juice and sparkling water) beverage type, store type (limited service vs supermarket/grocery), and area median household income (lower vs higher). Two-sample tests of proportions were conducted to compare correctly taxed purchases. The tax was correctly applied in 91.0% of cases. Correct tax application was found in 87.8% of taxable beverage purchases versus 97.3% of nontaxable beverage purchases (P = .10), 71.4% of juice drink purchases versus 95.6% of nonjuice drink purchases (P < .001), and 85.5% of limited service store purchases versus 100% of supermarket/grocery purchases (P = .01). No significant differences were found by area income.