Hii, M; Beyer, K; Namin, S; Malecki, K; Schultz, A; Rublee, C. (2021).

Respiratory diseases, racial disparities, and residential proximity to coal power plants in Wisconsin, USA: a cross-sectional study

File: Respiratory-diseases-racial-disparities-and-residential-proximity-to-coal-power-plants-in-Wisconsin-USA-a-cross-sectional-study.pdf

Respiratory diseases, racial disparities, and residential proximity to coal power plants in Wisconsin, USA: a cross-sectional study

  • AUTHORS: Hii, Michael; Beyer, Kirsten; Namin, Sima; Malecki, Kristen; Schultz, Amy; Rublee, Caitlin
  • PART OF The Lancet global health, 2021-03, Vol.9, p.S19-S19
    • The burning of fossil fuels, including coal, is the primary source of greenhouse gas emissions driving anthropogenic climate change and its associated health harms: heat-related illnesses, arboviral diseases, trauma from extreme weather events, allergies, and chronic disease exacerbations. Coal-fired power plants (CFPP) supply 23% of electricity in the USA and 42% for the state of Wisconsin. Air pollution from CFPP has been associated with respiratory diseases, cancers, cardiovascular and neurological disorders, especially for vulnerable populations. In this cross-sectional study, we aim to measure associations between respiratory diseases and residential proximity to CFPP. We obtained cross-sectional, population-based health data for non-institutionalised, non-active-duty adults from the Survey of the Health of Wisconsin database from 2008 to 2013. Pulmonary function was measured by spirometry as a ratio of forced expiratory volume in one second (FEV1) to forced vital capacity (FVC). An average of three or more FEV1/FVC readings <80% was considered abnormal and indicative of an obstructive disorder. We used multivariate regression analyses to evaluate pulmonary function and distance from CFPP, controlling for sex, education, race/ethnicity, age, asthma, and total years smoking history. We included data from 2327 adults aged 21–74 years in analysis. Adults living in close proximity to one of 11 CFPP had worse pulmonary function than did adults living more than 35 km away from CFPP with an odds ratio of 1·24 (95% CI 0·90–1·70). Although not statistically significant, trends suggest higher odds of obstructive pulmonary diseases in those living within 35 km of CFPP. Protective factors, in addition to distance, were higher education and younger age. Risk factors identified were older age and having a history of smoking. Although Black residents made up 4·8% of the total sample population, they accounted for 13·3% of people living within 35 km of CFPP. Similarly, Hispanic residents accounted for 4·8% of those living within 35 km of CFPP but only made up 2·8% of the sample population. Wisconsin CFPP might be associated with worse pulmonary function in people living at or within 35km of their locations, with possible consequences related to costly inhaler medications, health-care visits, and hospitalisations. When linked with socioeconomic factors, and race and ethnicity, closing down CFPP should be considered when addressing health disparities and environmental injustices. Affordable, clean energy solutions are readily available and just transitions have recently been demonstrated in North America. As nations recover from COVID-19, there is a profound opportunity for leaders across sectors to build healthier communities and prioritise climate action for health. Dr Elaine Kohler Summer Academy of Global Health Research and Wisconsin Partnership Program.

Ersig, A; Brown, R; Malecki, K. (2021).

Clinical measures of allostatic load in children and adolescents with food allergy, depression, or anxiety. DOI: 10.1016/j.pedn.2021.08.025

File: Clinical-measures-of-allostatic-load-in-children-and-adolescents-with-food.-Ersig-A.-Brown-R.-Malecki-K.-2021.pdf

Clinical measures of allostatic load in children and adolescents with food
allergy, depression, or anxiety


Ersig, Anne L; Brown, Roger L; Malecki, Kristen
Journal of pediatric nursing, 2021-11, Vol.61, p.346-354


Purpose: Sustained high stress exposure results in chronic activation of the stress response system, dysregulated stress responses, high allostatic load, and poor later-life health. Children and adolescents with chronic health conditions face stressors related to their condition in addition to those typical of childhood and adolescence, placing them at risk of high allostatic load. The purpose of this secondary analysis was to examine whether youth with chronic health conditions differ from controls on clinical measures of allostatic load.

Design and methods: A secondary analysis of two datasets, the electronic health record of a tertiary children’s hospital and data from the Survey of the Health of Wisconsin, compared youth with chronic health conditions to controls on clinical measures of allostatic load. Additional analyses explored whether parental stress and mental health influenced these relationships.

Results: Analyses identified differences in BMI, blood pressure, and waist circumference between youth with food allergy, anxiety, or depression, and controls. These relationships differed for males and females and for those with comorbid mental and physical conditions, and were influenced by parent stress and mental health.

Conclusions: Results support future studies exploring whether high stress in youth with chronic health conditions leads to increased allostatic load. Incorporating biomarkers as well as genetic and epigenetic factors will provide critical insights.

Practical implications: Youth with mental and physical CHCs may be at increased risk of high allostatic load, reflected in clinical measures of metabolism, and should have regular assessments of their metabolic health.

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