Hamilton County Research Articles

First-and-last mile solution via bicycling to improving transit accessibility and advancing transportation equity

The speed advantage of bicycling surpasses walking as a better solution to the first-and-last-mile problem, thus improving transit accessibility and equity. As more cities are investing in bike infrastructures, it's essential to estimate to what extent the transit accessibility can be increased through the bicycle-transit modal solution to ensure sound bike network planning. To address this uncertainty, this paper creates a quantity-based method to measure the pedestrian- and bicycle-transit accessibility on the basis of which impacts of bicycling and walking on transit accessibility are estimated and compared. Meanwhile, the benefit of bicycling the first-and-last mile to transportation equity is investigated among social groups defined by income and race. The case study of Hamilton County, Ohio demonstrates that the transit access distance by bicycling is tripled compared with that by walking. The extended access distance increases the transit job accessibility by 43.70%. Moreover, it advances transit equity, which is reflected in an upgraded transit accessibility to jobs for low incomes and minorities. The paper contributes to advancing understanding the capacity of bicycling as a first-and-last-mile connector to improve transit accessibility and equity. The developed methodology can serve as a tool to facilitate the bikeway planning for extending transit point-to-point mobility.

Neighborhood Poverty and Pediatric Intensive Care Use.

Disparities in health service use have been described across a range of sociodemographic factors. Patterns of PICU use have not been thoroughly assessed. This was a population-level, retrospective analysis of admissions to the Cincinnati Children's Hospital Medical Center PICU between 2011 and 2016. Residential addresses of patients were geocoded and spatially joined to census tracts. Pediatric patients were eligible for inclusion if they resided within Hamilton County, Ohio. PICU admission and bed-day rates were calculated by using numerators of admissions and bed days, respectively, over a denominator of tract child population. Relationships between tract-level PICU use and child poverty were assessed by using Spearman's ρ and analysis of variance. Analyses were event based; children admitted multiple times were counted as discrete admissions. There were 4071 included admissions involving 3129 unique children contributing a total of 12 297 PICU bed days. Child poverty was positively associated with PICU admission rates (r = 0.59; P < .001) and bed-day rates (r = 0.47; P < .001). When tracts were grouped into quintiles based on child poverty rates, the PICU bed-day rate ranged from 23.4 days per 1000 children in the lowest poverty quintile to 81.9 days in the highest poverty quintile (P < .001). The association between poverty and poor health outcomes includes pediatric intensive care use. This association exists for children who grow up in poverty and around poverty. Future efforts should characterize the interplay between patient- and neighborhood-level risk factors and explore neighborhood-level interventions to improve child health.

Characterization of Community-Based Socioeconomic Factors, Utilization, and Adherence in Children with Sickle Cell Disease

Introduction Sickle cell disease (SCD) affects over 100,000 people in the US, the majority of whom are African American. Socioeconomic challenges have a significant impact on both access and adherence to appropriate treatments which, given a history of racial segregation and discrimination, disproportionately burden under-represented minorities. The distribution of socioeconomic factors, like poverty, educational attainment, and housing quality, can now be assessed routinely at the population level, yet the distribution and impact of such contextual risks in the pediatric sickle cell population have not been sufficiently described. Here, we sought to characterize the burden of neighborhood-level socioeconomic challenges and barriers among children with SCD in one large, urban county. We also sought to determine whether these area-level indicators were associated with hospitalizations and markers of adherence to SCD medications. Methods We pursued a retrospective review of electronic health record data from 2011-2017 for children with HbSS disease in the active Cincinnati Children's Hospital Medical Center's SCD registry which includes all children receiving care within the past two years in the Comprehensive Sickle Cell Center and is representative of nearly all children with SCD in Hamilton County, Ohio. The analysis was performed under an IRB-approved study investigating socioeconomic factors for children in Hamilton County. Children within the SCD registry were excluded from this analysis if they had a non-HbSS genotype or an address outside of Hamilton County. Addresses were geocoded and linked to a specific census tract which approximates local neighborhood boundaries. Once linked to a census tract, that address was connected to a pre-determined list of variables present within the 2013-2017 US Census' American Community Survey. Variables included the census tract poverty rate, educational attainment rate (percentage of adults with less than a high school education), and the percentage of vacant housing. A validated census tract-level deprivation index, assembled from 6 such census variables, was also included. Outcomes of interest included number of hospitalizations and ED visits during the study period and %HbF for the subset on hydroxyurea treatment. Descriptive statistics were used to illustrate ecological socioeconomic characteristics among included patients. Associations between area-based socioeconomic deprivation and outcomes of interest were tested using the Kruskal-Wallis Test. Results There were 141 patients with HbSS included in the analysis (53% Male, 82% publicly insured). Mean age at the end of the analysis period was 9.6±6.3 years. Consistent with the aggressive treatment strategy at our center, most (97%) were on disease modifying treatment with either hydroxyurea (81%) or chronic transfusion therapy (16%). Compared to the county as a whole, children in the registry mapped to areas with relatively high rates of poverty (median 26%; IQR 15%-42%), low rates of education attainment (median with high school degree 86%; IQR 78%-91%), and high rates of vacant housing (median 13%; IQR 8%-19%). The deprivation index is scaled between 0 and 1 with higher values indicative of more socioeconomic deprivation. In our population, the deprivation index median was 0.45 (IQR 0.36-0.61). When the sample was categorized into three deprivation groups (low &lt; 25th percentile, medium between 25th and 75th, and high &gt;75th percentile), we found trends toward associations with utilization and adherence measures (Table 1). Conclusion A majority of our SCD patients live in neighborhoods with stark socioeconomic challenges and barriers which have been shown to negatively affect health outcomes. There appears to be a significant trend towards increased utilization among those living in more deprived neighborhoods, although, the link with adherence was less clear. The latter finding, indicative of similar HbF levels across deprivation groupings, may be the result of efforts made by our multidisciplinary comprehensive care team to optimize care for all patients regardless of socioeconomic challenges. The data presented here are novel and likely representative of socioeconomic challenges of most SCD patients living in the US. Future, larger, multi-center studies should focus on identifying and addressing social determinants of health within this population. Disclosures No relevant conflicts of interest to declare.

Development and Pilot Installation of a Scalable Environmental Sensor Monitoring System for Freeze–Thaw Monitoring under Granular-Surfaced Roadways

The freeze–thaw cycle is one of the major sources of damage to granular-surfaced roadways, especially in areas where the timing of heavy agricultural traffic coincides with that of spring thawing. To help local roads agencies plan better for annual budgets and frost embargos, it is useful to be able to predict the frost depth and number of freeze–thaw cycles under a given roadway based on continually updated weather and soil data. Computational modeling can help in this regard, and may be conducted by collecting data on weather and the thermal and hydraulic properties of the soil, as well as soil temperature, moisture, and suction, and using the data directly in the analyses. In order to obtain accurate field data for model calibrations and predictions, an appropriate sensor network and data acquisition system must be carefully planned and installed. This article details the development and installation procedures for one such system of sensors for subgrade temperature, water content, and matric suction, and presents lessons learned throughout the process. Various issues are discussed relating to selection of the sensor and data acquisition system, laboratory and field checks, borehole sensor installation tools, and post-installation troubleshooting and monitoring. To ensure a successful installation beneath the granular roadway, laboratory and field trials were first performed. Salient details of a pilot installation in Hamilton County, IA are provided to guide others developing and scaling similar subgrade sensor systems.

Field Investigation of Clay Balls in Full-Depth Asphalt Pavement.

Clay ball is a pavement surface defect which refers to a clump in which clay or dirt is mixed with hot asphalt mixture. Clay ball is typically caused by a combination of aggregate contamination of clay or soil, high aggregate moisture, and low production temperature at the asphalt plant. It usually appears a few weeks or months after paving under traffic load, after being liquefied and knocked from the pavement surface. Clay balls can be the source of potholing, raveling, and other issues such as moisture infiltration and reduced ride quality. This paper presents an investigation of the clay balls on US-31 one winter after construction in Hamilton County, Indiana. In order to understand the pavement condition, their severity was measured using both visual observation and infrared image collection system. In addition, a clay ball amount, its distribution pattern, and cores condition were evaluated. A precipitation effect on clay ball formation was investigated for finding a cause of the clay balls. The investigation found that infrared image collection system was appropriate in detecting the clay balls. The clay balls were elliptic in shape with 2.5 cm to 10 cm in diameter, and the maximum clay ball depth was almost penetrating the entire surface course. It was also found that the asphalt paving on the raining days or right after raining could increase the potential of clay balls. Monitoring of aggregate moisture during construction on or after raining days should be able to reduce the risk of clay balls.

Mapping Honeysuckle Distribution in Large Forests through Use of High Resolution Satellite Images – Case Study at Great Parks of Hamilton County, Ohio, USA

A non-native invasive shrub, named Amur honeysuckle, has caused various problems to the habitats of native plants and animals. Local governments, private landowners and non-profit groups spend numerous efforts on removing these species from forests. The first step to remove the species is to know their spatial distribution. The major objective of this study is to explore how to quickly map honeysuckle distribution by using high resolution satellite images. The case study is located in Great Parks of Hamilton County (GPHC), Ohio. A World-View2 satellite image acquired on Nov. 9th 2013 was classified into several land use types, including low density honeysuckle area, medium/high density honeysuckle area, grass/crop, bare soil/construction, and water/wet land. Half of the field data that we collected in Nov. 2013 and some high resolution aerial photos (with 4 inch spatial resolution) were used to validate the classification result. The study result demonstrates that the World-View2 image delineates honeysuckle distribution fairly well, in particular, for medium/high density honeysuckle areas. As a pilot program utilizing advanced geospatial analysis, this project will provide important information for understanding the status of wildlife habitats and for implementing site-specific management in parks and nature preserves.

Regional techno‐economic and life‐cycle analysis of the pyrolysis‐bioenergy‐biochar platform for carbon‐negative energy

AbstractThis study investigates the sensitivity of greenhouse gas (GHG) emissions and the minimum fuel selling price for a 2000 metric ton day−1 integrated pyrolysis‐bioenergy‐biochar platform with respect to the biorefinery location and biomass types. The regional techno‐economic and life‐cycle analysis is evaluated in three US counties using representative crops: rice in Glenn County (California), corn in Hamilton County (Iowa), and peanuts in Jackson County (Florida). We evaluate the biochar selling price considering crop yield increases of 0.6%, 2.9%, and 10% after biochar application over 20 years in Glenn County, Hamilton County, and Jackson County, respectively. The biochar prices are calculated under low and high commodity prices to determine upper and lower bounds. Jackson County has the most economically beneficial scenario with an average minimum fuel selling price (MFSP) of $1.55 gal−1 of biofuel produced whereas Hamilton County has the highest average MFSP of $3.82 gal−1. The life‐cycle analysis shows that woody biomass has a strong potential to produce carbon‐negative energy compared to grass and straw. Of the 304 cases scenarios considered for this platform, 64% could produce biofuel with negative GHG emissions, which would meet the Renewable Fuel Standard (RFS) target for cellulosic biofuels. © 2019 Society of Chemical Industry and John Wiley &amp; Sons, Ltd

A runoff trading system to meet watershed-level stormwater reduction goals with parcel-level green infrastructure installation

Green infrastructure (GI) has been recommended widely to reduce runoff from the built environment. However, reliance on public land for GI implementation could cause a heavy financial burden on local governments. Although economic incentives and market-based mechanisms may encourage public participation in managing stormwater by installing GI on private parcels, a runoff trading market has not been fully developed in practice. To establish a market, in part, requires a watershed-based planning framework and fully informed parcel owners in regard to tradable credits, costs, and benefits. We propose a scenario-based Stormwater Management Planning Support System for Trading Runoff Abatement Credits (SMPSS-TRAC) to facilitate the calculation and allocation of stormwater runoff abatement credits in order to assist the decision-making of GI investment. We apply SMPSS-TRAC to a watershed located in Hamilton County, Ohio, USA and develop five scenarios representing increasing use of GI. We test the scenarios under a 5-year rainfall intensity and set a cap of runoff for each scenario at a level that is equal to the runoff from an undeveloped status (1.03-inch runoff depth for the watershed). With the proposed SMPSS-TRAC, the watershed authority could encourage all parcel owners to install suitable GI or purchase credits from the market. When detention basins are needed to meet a stated goal, the watershed authority would build them on vacant lots and share costs with all parcels within the same sub-catchment. The last scenario with four types of GI installed, shows that the watershed reaches market equilibrium and generates 15,358 m3 credit surplus. SMPSS-TRAC has the potential for including multiple stakeholders' preferences and concerns in searching for preferable scenarios.

Excessive Force Was Not Used in Arrest of Mentally Ill Man Who Died Shortly After Restraint

In Roell v. Hamilton County , 870 F.3d 471 (6th Cir. 2017), the U.S. Court of Appeals for the Sixth Circuit upheld that Gary Roell's Fourth Amendment right to be free from excessive force was not violated. The opinion affirmed the district court granting summary judgment to the arresting officers

Prioritizing Natural Areas for Habitat Restoration in Parks of Hamilton County through Use of GIS

The majority of land within Great Parks of Hamilton County (GPHC), Ohio, USA, is managed as natural area; and while threats to preservation are growing more numerous, resources to manage these natural areas are limited. We develop a quick method for GPHC staff to prioritize the natural areas in GPHC parks through the use of GIS tools and existing data. This study applies the scoring approach, which evaluates candidate sites individually using scores for multiple factors and then selects priority sites from the top of a ranked list. Three sets of multiple factors are used to compute the prioritization index, and they generate similar priority index maps. This method will help GPHC staff to make a better plan for habitat restoration activities in their parks.

Association of an Asthma Improvement Collaborative With Health Care Utilization in Medicaid-Insured Pediatric Patients in an Urban Community

CM Kercsmar, AF Beck, H Sauers-Ford JAMA Pediatr. 2017;171(11):1072–1080 To reduce asthma health care use for Medicaid pediatric patients residing in the county surrounding Cincinnati, Ohio. An estimated 36 000 children ages 2 to 17 years who resided in Hamilton County, had a diagnosis of asthma, and were Medicaid insured were studied over a 6-year period. Approximately 13 000 were Medicaid insured. From January 1, 2010, through December 31, 2015, a multidisciplinary team used an integrated, multilevel approach focused on enhancing availability and accessibility of treatments, removing barriers to adherence, mitigating risks related to adverse exposures, and augmenting self-management and collaborative relationships between the family and …

Bi-level optimization approach for configuring population and employment distributions with minimized vehicle travel demand

Compact development aims to lead to dense and mixed distributions of population and employment in land use planning which may result in reduced vehicle miles traveled (VMT). However, determining an optimum or desirable configuration of population and employment distribution to achieve the compact development goal remains challenging due to numerous competitive development alternatives or possible exacerbated traffic congestion as a result of over-intensification of urban land use. To address this challenge, a systematic approach is proposed with a bi-level optimization model aiming to find out an efficient population and employment map for vehicle travel reduction. The upper level of the model is formulated to minimize VMT and vehicle hours traveled (VHT) varying with possible changes in population and employment densities. The lower level is based on a tour-based travel demand model to mechanistically represent the response of travel choices to those changes. The programming is solved by a Genetic Algorithm. The proposed method is demonstrated through a case study of Hamilton County, Ohio, U.S. The results indicate that a more compact urban form reduces VMT; however, it may cause longer VHT depending upon the density. To avoid urban overconcentration and reduce both VMT and VHT simultaneously, a compact urban development configuration with a population density < 5289 persons/mi2 and the employment density < 3282 jobs/mi2 is recommended for the area. As a negative relationship demonstrated between transit headway reduction and vehicle travel demand, strategies for improving transit provision are helpful to reducing vehicle travels in compact development scenarios.

Under the Law

The Individuals with Disabilities Education Act (IDEA) requires that students with disabilities be educated in the least restrictive environment, meaning the environment that is as close as possible to that of a regular education classroom. However, the nation’s various circuit courts have used different standards to determine whether a particular placement meets this requirement. Julie Underwood summarizes a recent Sixth Circuit case, L.H. v. Hamilton County Department of Education, in which the court ruled that it was inappropriate for a district to remove a child with Down syndrome from a regular classroom, where he was making academic progress but not achieving the grade-level standard.

A noteworthy accumulation of disparid crinoids from the type Cincinnatian (Upper Ordovician) of southwestern Ohio, USA: implications for the palaeoecology and taphonomy of crinoid “logjam” assemblages

Crinoids are a common and well-studied faunal component of the Upper Ordovician (Katian; Edenian) Kope Formation in the greater Cincinnati Arch region, USA. However, a relatively fresh outcrop exposing the Southgate and McMicken members of the Kope Formation at Cleves, Hamilton County, southwestern Ohio, has yielded a crinoid specimen worthy of description and comment. The specimen is a “logjam” of numerous articulated columns of Iocrinus subcrassus displaying parallel alignment, reflecting the influence of storm-generated currents. Iocrinus is not typically found in such a state; the genera Ectenocrinus and Cincinnaticrinus are generally associated with “logjams” in the type Cincinnatian, making this an unusual occurrence. At least one of the columns has the coiled dististele of another, smaller I. subcrassus tightly wrapped around it. Although I. subcrassus is known to employ a coiled dististele as an attachment strategy, ramose bryozoans are generally utilised as substrates and tight coiling around larger I. subcrassus columns has not previously been reported. Preservation of coiled dististeles, in general, is a feature not previously documented in Cincinnatian crinoid “logjams.” This specimen illustrates that unusual, noteworthy and/or rare material representing relatively common organisms continue to be discovered even within extensively studied units in the type Cincinnatian.

Emergency Medical Services Utilization Is Associated With Community Deprivation in Children

Background: Pediatric emergency medical services (EMS) utilization is costly and resource intensive; significant variation exists across large-scale geographies. Less is known about variation at smaller geographic levels where factors including lack of transportation, low health literacy, and decreased access to medical homes may be more relevant. Our objective was to determine whether pediatric EMS utilization varied across Hamilton County, Ohio, census tracts and whether such utilization was associated with socioeconomic deprivation. Methods: This was a retrospective analysis of children living in Hamilton County, Ohio, transported by EMS to the Cincinnati Children’s emergency department between July 1, 2014, and July 31, 2016. Participants’ addresses were assigned to census tracts and an EMS utilization rate and deprivation index were calculated for each. Pearson’s correlation coefficients evaluated relationships between tract-level EMS utilization and deprivation. Tract-level deprivation was used as a predictor in patient-level evaluations of acuity. Results: During the study period, there were 4,877 pediatric EMS transports from 219 of the 222 county census tracts. The county EMS utilization rate during the study period was 2.4 transports per 100 children (range 0.2–11). EMS utilization rates were positively correlated with increasing deprivation (r = 0.72, 95% confidence interval [CI], 0.65–0.77). Deprivation was associated with lower illness severity at triage, fewer transports resulting in resuscitation suite use, and fewer transports resulting in hospitalizations (all p < 0.05). Conclusions: EMS utilization varied substantially across census tracts in Hamilton County, Ohio. A deeper understanding into why certain socioeconomically deprived areas contribute to disproportionately high rates of EMS utilization could support development of targeted interventions to improve use.

Developmental Disorders and Medical Complications Among Infants with Subclinical Intrauterine Opioid Exposures.

The objective was to compare diagnosis rates representing developmental outcomes and medical complications between infants with intrauterine opioid exposures who did not receive pharmacologic treatment for neonatal abstinence syndrome at the time of birth and infants for whom no exposure to substances of abuse were detected. This retrospective, descriptive study included approximately 95% of Hamilton County, Ohio resident births in 2014 and 2015. Universal maternal drug test results, performed at the time of birth, were documented and linked to electronic health records representing pediatric primary and subspecialty follow-up care as well as urgent care, emergency care, and inpatient services provided by Cincinnati Children's Hospital Medical Center through 2017, when all children were at least 24 months old. Diagnosis rates were compared between drug exposure groups using chi-square tests. Among infants born at >34 weeks gestation and without other complex clinical conditions, infants with subclinical opioid exposures (N = 473) were more likely than infants with no drug exposures (N = 14,933) to be diagnosed with behavioral or emotional disorders (3.0% vs 1.1%, P = 0.0008), developmental delay (15.6% vs 7.6%, P < 0.0001), speech disorder (10.1% vs 6.5%, P = 0.001), or strabismus (3.4% vs 1.0%, P < 0.0001), and more likely to be exposed to the hepatitis C virus (6.8% vs 0.1%, P < 0.0001). Increased diagnosis rates among all opioid exposed infants, regardless of withdrawal severity, may warrant the additional allocation of resources for screening and follow-up. Awareness of the increased risk for certain developmental delays and medical conditions is critical to early intervention and treatment supporting improved outcomes.

Pervasive Income-Based Disparities In Inpatient Bed-Day Rates Across Conditions And Subspecialties.

Building a culture of health in hospitals means more than participating in community partnerships. It also requires an enhanced capacity to recognize and respond to disparities in utilization patterns across populations. We identified all pediatric hospitalizations at Cincinnati Children's Hospital Medical Center, in the period 2011-16. Each hospitalized child's address was geocoded, allowing us to calculate inpatient bed-day rates for each census tract in Hamilton County, Ohio, across all causes and for specific conditions and pediatric subspecialties. We then divided the census tracts into quintiles based on their underlying rates of child poverty and calculated bed-day rates per quintile. Poorer communities disproportionately bore the burden of pediatric hospital days. If children from all of the county's census tracts spent the same amount of time in the hospital each year as those from the most affluent tracts, approximately twenty-two child-years of hospitalization time would be prevented. Of particular note were "hot spots" in high-poverty census tracts neighboring the hospital, where bed-day rates were more than double the county average. Hospitals that address disparities would benefit from a more comprehensive understanding of the culture of health-a culture that is more cohesive inside the hospital and builds bridges into the community.

Water Balance Modeling of Temporary Ponding in a Drained Prairie Pothole Wetland

Farmed pothole depressions, common in the Prairie Pothole Region, frequently hold water during wet periods and play an important role in ecosystem dynamics such as flood retention and hosting migratory waterfowl. In this study, we developed a spreadsheet-based daily water budget model of a drained and farmed pothole in Hamilton County, Iowa, to evaluate how site-specific characteristics affect the frequency, depth, and duration of surface ponding. For a 3-year period characterized by a range of precipitation, the model predicted that on an annual basis ponded water would be present in the pothole approximately 14 to 47% of the time. Total ponding days ranged from 51 to 173 days year−1 and maximum ponding depth ranged from 112 to 334 mm. Infiltration rate, catchment-to-pothole ratio, and the presence of a surface intake had the largest impact on ponding depth and duration. Results of this study have implications for management of farmed and drained potholes and we can envision using the PPWB model to test potential strategies for pothole management from both agricultural profitability and ecological perspectives.

Glenathe salina (Diptera: Ephydridae): New Freshwater, Saline Habitat and County Records in Ohio

The collection of Glenanthe salina Mathis in a freshwater restored wetland in Hamilton County, Ohio is a new county record and represents a significant range extension within the state. For the first time, G. salina was collected from an Ohio saline habitat (Wayne County) and is a new county and an eastern North American inland salt habitat record. Glenanthe salina records from freshwater, saline, and alkaline habitats suggest broad osmoregulation capacity. Collection records suggest that G. salina and Psilopa girschneri colonized saline habitats at Rittman, Ohio during 1996 and 1976, respectively. During the early half of the twentieth century, hyper saline habitat at Rittman, Ohio was colonized by Ephydra gracilis Packard, and E. niveiceps Cresson, which have been commonly reported from saline habitats in western North America.

Surveillance of Intrauterine Opioid Exposures Using Electronic Health Records.

The objective was to use population-based electronic health records for surveillance of intrauterine exposures to substances of abuse, including opioids, and to monitor changes in exposure rates over time. This retrospective, descriptive analysis utilized geocoded neonatal physician billing records representing intrauterine exposures to substances of abuse detected through universal maternal drug testing. Census tract-level exposure rates were identified among the newborn population of Hamilton County, Ohio between 2014 and 2016. Among 27,896 newborns, the authors detected an intrauterine opioid exposure rate of 37.9 per 1000 infants, with 10.5 per 1000 experiencing severe opioid withdrawal (neonatal abstinence syndrome). Individual data were mapped to 222 US census tracts. Tract-level opioid exposure rates ranged from 0.0 to 607.1 (median: 32.9) per 1000 live births. Secondary use of electronic health record data has potential to aid in intrauterine opioid exposure and other public health surveillance efforts without disrupting clinical workflows or placing an additional burden on limited resources. Surveillance of intrauterine opioid exposures may inform stakeholders and enable targeting of interventions and prevention strategies toward the highest risk populations.