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Browsing by Author "Pusker, Stephanie, author"

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    Colorado EnviroScreen as a predictor of mortality: an ecological analysis of 2019 county-level data
    (Colorado State University. Libraries, 2024) Pusker, Stephanie, author; Rojas-Rueda, David, advisor; Clark, Maggie, advisor; Gutilla, Molly, committee member
    Background In today's rapidly evolving landscape of environmental awareness in public health, Colorado stands at the forefront of innovation with its Environmental Justice (EJ) mapping and health screening tool, Colorado EnviroScreen (Colorado EnviroScreen, 2022). This tool, developed by Colorado Department of Public Health and Environment (CDPHE), empowers governmental agencies, research institutions, and the broader public to quantify and understand the interplay between environmental factors and community health by calculating an "EnviroScreen Score" (Colorado EnviroScreen, 2022). The higher the EnviroScreen score, the more likely the area will be affected by environmental health injustices at the census block group, census tract, and/or county levels (Colorado EnviroScreen, 2022). The purpose of this study is to bridge a gap in the current research landscape by exploring the association between aggregate county-level data derived from an EJ mapping tool and all-cause mortality rates. Specifically, we aim to investigate the relationship between the CO EnviroScreen score and the component scores – Demographics, Sensitive Populations, Climate Vulnerability, Environmental Effects, and Environmental Exposures – and all-cause mortality rates at the county level in Colorado in 2019. By conducting this ecological analysis, we seek to provide valuable insights into the potential impact of environmental justice factors on public health outcomes, thereby contributing to a more comprehensive understanding of the interaction between environmental conditions and mortality rates within communities. Methods An ecological study was conducted at the county-level spatial scale using a generalized linear model to assess the association between three EnviroScreen component score percentiles (Demographics, Environmental Exposures, and Climate Vulnerability) and age-standardized all-cause mortality at the county level. These three score percentiles were selected due to correlation with other scores, as well as the indicators included in some of the component scores being more comprehensive than others. County-level covariates included in the model were insufficient sleep, alcohol overindulgence, physical inactivity, and smoking. In addition to the full model, secondary models were created, including Demographics, Environmental Exposures, and Climate Vulnerability as independent predictors. Furthermore, the total EnviroScreen score percentile, which includes all component scores, was used in the analysis. Results In the fully adjusted model, a 10% increase in the EnviroScreen Environmental Exposures component score was associated with a 3% increase in all-cause mortality rate at the county level in Colorado in 2019 (95% CI: 1.00, 1.05). In the crude model, a 10% increase in EnviroScreen score was associated with a 5% increase in all-cause mortality rate at the county level in Colorado in 2019 (95% CI: 1.03, 1.07). Neither Demographics nor Climate Vulnerability component scores percentile were associated with an increase or decrease in all-cause mortality rates. Discussion This study suggests that there is a potential association between a higher EnviroScreen component score and an increase in age-standardized, all-cause mortality at the county level in Colorado. This is the first study to estimate the association between aggregate environmental and health-related scores from CO EnviroScreen with mortality. This study supports the notion of cumulative impacts as a tool to monitor possible health disparities and environmental injustice.