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  1. Objective:

    Although extreme heat can impact the health of anyone, certain groups are disproportionately affected. In urban settings, cooling centers are intended to reduce heat exposure by providing air-conditioned spaces to the public. We examined the characteristics of populations living near cooling centers and how well they serve areas with high social vulnerability.


    We identified 1402 cooling centers in 81 US cities from publicly available sources and analyzed markers of urban heat and social vulnerability in relation to their locations. Within each city, we developed cooling center access areas, defined as the geographic area within a 0.5-mile walk from a center, and compared sociodemographic characteristics of populations living within versus outside the access areas. We analyzed results by city and geographic region to evaluate climate-relevant regional differences.


    Access to cooling centers differed among cities, ranging from 0.01% (Atlanta, Georgia) to 63.2% (Washington, DC) of the population living within an access area. On average, cooling centers were in areas that had higher levels of social vulnerability, as measured by the number of people living in urban heat islands, annual household income below poverty, racial and ethnic minority status, low educational attainment, and high unemployment rate. However, access areas were less inclusive of adult populations aged ≥65 years than among populations aged <65 years.


    Given the large percentage of individuals without access to cooling centers and the anticipated increase in frequency and severity of extreme heat events, the current distribution of centers in the urban areas that we examined may be insufficient to protect individuals from the adverse health effects of extreme heat, particularly in the absence of additional measures to reduce risk.

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    Free, publicly-accessible full text available November 1, 2024
  2. Abstract Background Polycystic ovary morphology (PCOM) is an ultrasonographic finding that can be present in women with ovulatory disorder and oligomenorrhea due to hypothalamic, pituitary, and ovarian dysfunction. While air pollution has emerged as a possible disrupter of hormone homeostasis, limited research has been conducted on the association between air pollution and PCOM. Methods We conducted a longitudinal cohort study using electronic medical records data of 5,492 women with normal ovaries at the first ultrasound that underwent a repeated pelvic ultrasound examination during the study period (2004–2016) at Boston Medical Center. Machine learning text algorithms classified PCOM by ultrasound. We used geocoded home address to determine the ambient annual average PM 2.5 exposures and categorized into tertiles of exposure. We used Cox Proportional Hazards models on complete data ( n  = 3,994), adjusting for covariates, and additionally stratified by race/ethnicity and body mass index (BMI). Results Cumulative exposure to PM 2.5 during the study ranged from 4.9 to 17.5 µg/m 3 (mean = 10.0 μg/m 3 ). On average, women were 31 years old and 58% were Black/African American. Hazard ratios and 95% confidence intervals (CI) comparing the second and third PM 2.5 exposure tertile vs. the reference tertile were 1.12 (0.88, 1.43) and 0.89 (0.62, 1.28), respectively. No appreciable differences were observed across race/ethnicity. Among women with BMI ≥ 30 kg/m 2 , we observed weak inverse associations with PCOM for the second (HR: 0.93, 95% CI: 0.66, 1.33) and third tertiles (HR: 0.89, 95% CI: 0.50, 1.57). Conclusions In this study of reproductive-aged women, we observed little association between PM 2.5 concentrations and PCOM incidence. No dose response relationships were observed nor were estimates appreciably different across race/ethnicity within this clinically sourced cohort. 
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  3. Abstract

    Greenspace in schools might enhance students' academic performance. However, the literature—dominated by ecological studies at the school level in countries from the Northern Hemisphere—presents mixed evidence of a beneficial association. We evaluated the association between school greenness and student‐level academic performance in Santiago, Chile, a capital city of the Global South. This cross‐sectional study included 281,695 fourth‐grade students attending 1,498 public, charter, and private schools in Santiago city between 2014 and 2018. Student‐level academic performance was assessed using standardized test scores and indicators of attainment of learning standards in mathematics and reading. School greenness was estimated using Normalized Difference Vegetation Index (NDVI). Linear and generalized linear mixed‐effects models were fit to evaluate associations, adjusting for individual‐ and school‐level sociodemographic factors. Analyses were stratified by school type. In fully adjusted models, a 0.1 increase in school greenness was associated with higher test scores in mathematics (36.9 points, 95% CI: 2.49; 4.88) and in reading (1.84 points, 95% CI: 0.73; 2.95); as well as with higher odds of attaining learning standards in mathematics (OR: 1.20, 95% CI: 1.12; 1.28) and reading (OR: 1.07, 95% CI: 1.02; 1.13). Stratified analysis showed differences by school type, with associations of greater magnitude and strength for students attending public schools. No significant associations were detected for students in private schools. Higher school greenness was associated with improved individual‐level academic outcomes among elementary‐aged students in a capital city in South America. Our results highlight the potential of greenness in the school environment to moderate educational and environmental inequalities in urban areas.

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