Lake County Research Articles

Breast Cancer Disparities Among Women in Underserved Communities in Northwest Indiana

Background: Breast cancer is the second most common cancer found in women, after skin cancers. Research has discovered that factors such as race, socioeconomic status, and education affect both screening levels and cancer staging at diagnosis. Black women as well as lower-income individuals usually have higher grade staging as well as higher mortality. Since Lake County medical systems serve both high and low-income communities we wanted to analyze breast cancer staging in Lake County to see how it compares to national trends.
 Methods: “Hospital A” provided data from 393 positive breast cancer diagnoses along with the clinical staging at diagnosis from January 2019 to December 2022 for both high and low-income neighborhoods. Using a Mantel-Haenszel chi-square test we compared staging levels among the different income neighborhoods as well as among different races.
 Results: When looking at total staging data from 2019-2022, there was a significant difference between the race category of "Black or African American" and "White" population staging data. White patients tend to have lower stages, during initial clinical diagnosis, compared to Black patients. The "Other" category, which included all other races that did not fit into the "Black or African American" or "White Category" such as Asians, also had lower staging upon diagnosis when compared to the “Black or African American” group but no statistically significant difference with the “White” population.
 Conclusion: Our data showed that in Lake County, Indiana there are disparities in cancer staging among both income levels as well as race. The lower-income areas in our study were correlated with a greater proportion of Black residents as compared to the higher income areas. This data shows that Lake County needs to be more proactive in screening its minority communities.

Air quality sensors and distributional environmental justice: a case study of Salt Lake County, Utah

ABSTRACT Ambient fine particulate matter (PM2.5) causes health problems and is monitored by U.S. federal and state governments. Due to gaps in public monitoring, people rely on non-regulatory air quality monitoring networks (NAQMNs), comprised of low-cost PM2.5 sensors, to obtain air quality information. While environmental justice studies have examined social disparities in PM2.5 and sensor distribution, none have examined disparities in university-purchased vs. privately-purchased sensor distributions. This is important because who purchases sensors (and why) may impact sensor distribution equity. Using multivariable generalized estimating equations, we investigate university-purchased (n=68) and privately-purchased (n=230) sensors in the Salt Lake County, Utah NAQMN with a focus on socioeconomic status (SES), race/ethnicity/immigrant status, and PM2.5 at the census tract-level (n=208). Tracts with higher SES and PM2.5 concentrations had increased sensors per resident. Findings related to SES attenuate when predicting university-purchased vs. privately-purchased sensors. Tracts with greater Hispanic immigrant populations and higher PM2.5 concentrations had increased access to university-purchased sensors. Tracts with higher Asian concentrations were underserved regardless of sensor purchaser. This approach illuminates how university-purchased sensors may enhance distributional environmental justice. Findings have implications for enhancing equitable sensor distribution in NAQMNs.

“It’s Not a Top Priority”: A Qualitative Analysis of Provider Views on Barriers to Reproductive Healthcare Provision for Homeless Women in the United States

ABSTRACT Women experiencing housing insecurity are at an elevated risk for adverse reproductive health outcomes due to the prevalence of chronic health conditions and higher risk behaviors. Social service and healthcare providers are front line in addressing women’s needs when they seek support. Thus, we sought to explore reproductive healthcare barriers using in-depth interviews with 17 providers at 11 facilities serving housing-insecure women in Salt Lake County, Utah, USA from April to July 2018. Providers noted a number of system-, provider-, and individual-level barriers. Dominant themes include reliance on unstable funding, lack of provider training on reproductive health, and perceived logistical challenges to care. Due to the prevalence of immediate needs among housing-insecure women, providers attest that reproductive health needs often do not emerge as their urgent concern. Our findings suggest that addressing policy and funding challenges to prioritizing reproductive needs among housing-insecure women can help mitigate the potential for long-term adverse reproductive outcomes.

Urban form, air pollution, and walking behavior: A study of Salt Lake County, Utah

IntroductionWalkability is an essential concern in urban and public policy, as it is highly related to public health, social equity, and climate change. This paper examines the impacts of urban space and air pollution on walking behaviors across census block groups in Salt Lake County (SLCo), Utah, including walking trip origins, destinations, and paths. MethodsLocal Moran's I index is applied to capture the spatial clustering of walking behaviors. Non-spatial and spatial generalized linear models based on the quasi-Poisson function were then comparatively constructed to explore the relationships between urban form, air pollution, and walking behavior, using walking time and frequency as dependent variables. ResultsWe found that downtown Salt Lake City was the main place for walking activities, and more walking activities occurred in eastern SLCo than in the western part, while the western part has a higher concentration of minority populations. Compact development may promote local walking behavior, but types of mixed land use matter: while job mixture was a catalyst for walking, job-housing mixture was not. Concerning the role of air pollution, particulate matter and volatile organic compounds significantly reduced the length of walks. However, taking frequent short walks might further expose people to pollutants such as ammonia and sulfur oxides in urban centers. ConclusionsThis study explored the intra-urban relationships between urban form, air pollution, and walkability. Air pollution is a critical concern for walkability. Promoting compact development alone is insufficient; efforts should also be made to improve job mixture, reduce air pollution, and, more broadly, promote polycentric development.

Seismic and Liquefaction Hazard Maps for Five Western Tennessee Counties

Abstract A five-year seismic and liquefaction hazard mapping project for five western Tennessee counties began in 2017 and supported natural hazard mitigation efforts in Lake, Dyer, Lauderdale, Tipton, and Madison counties. Additional geological, geotechnical, and geophysical information has been gathered in all five counties to improve the base northern Mississippi Embayment hazard maps of Dhar and Cramer (2017). Information gathered includes additional geological and geotechnical subsurface exploration logs, water table level data collection, new measurements of shallow shear-wave velocity (VS) profiles, and the compilation of existing VS profiles in and around the counties. Improvements have been made in the 3D geological model, water table model, the geotechnical liquefaction probability curves, and the VS correlation with lithology model for these counties. The resulting updated soil response amplification distributions on a 0.5 km grid were combined with the 2014 U.S. Geological Survey seismic hazard model (Petersen et al., 2014) earthquake sources and attenuation models to add the effect of local geology for Lake, Dyer, Lauderdale, Tipton, and Madison Counties. The resulting products are similar to the Memphis and Shelby County urban seismic hazard maps recently updated by Cramer, Dhar, and Arellano (2018). Generally, the effect of local geology is to reduce seismic hazard at short periods and increase it at long periods. Liquefaction hazard is high only in the alluvial lowlands, but not in the loess covered uplands.

Coping with Community Violence: Perspectives of African American Young Adult Men and Hispanic/Latino Young Adult Men.

Further study is needed regarding the intersection of community violence exposure, coping strategies, and health behaviors among young adult African American men and Hispanic/Latino men. This study did so in Lake County, Indiana, which contains multiple areas with disproportionate prevalence of violence relative to population size. Approximately 22 miles from Chicago, Lake County includes noteworthy mid-sized cities such as Gary, Hammond, and East Chicago. This study explored the perceptions of African American men and Hispanic/Latino men ages 18 to 25 regarding coping strategies and both healthy and health risk behaviors after directly witnessing or indirectly experiencing a violent act or event. We used aspects of social cognitive theory to design this community-based participatory research study. Thirteen males who self-identified as African American, Hispanic/Latino, or both, completed 34- to 80-minute, audio-recorded phone interviews. Audio recordings were transcribed, and NVivo 12 Windows was used by the research team (primary researchers and two coders) to complete transcript analysis. Findings from this study provided insight around African American men and Hispanic/Latino men regarding (a) witnessing violence directly or indirectly experiencing violence; (b) changes in everyday life experiences; (c) coping strategies that involved socio-emotional health, spiritual health, social health, and risky health behaviors; (d) rationales for not asking for help; (e) observations of significant others' coping; (f) what to do differently in the future; (g) beliefs about mentors; and (h) beliefs about mental health providers. Delving into participants' experiences revealed that African American men and Hispanic/Latino men in Lake County, Indiana chose to adopt a range of health risk and health positive strategies after directly witnessing or indirectly experiencing violence. Becoming knowledgeable about African American men's and Hispanic/Latino men's diverse coping strategies and health behaviors may help inform the community about how best to cocreate spaces that aim to alleviate the traumatic experience of having directly or indirectly experienced community violence.

Recalibrating the management of resources in emergency response

AbstractThis article is an example of ‘Lessons from the Field’. Traditionally, preparedness activities emphasize acquisition of resources and the evaluation of resource capabilities. However, as local health departments (LHDs) move into a post‐coronavirus disease 2019 (COVID‐19) reality, we suggest greater emphasis be placed on the management of resources. In other words, all‐hazards planning should include policies that empower incident management personnel to complete specific tasks and procedures that ensure adequate and equitable resource deployment. Although resource management looks different for every organisation, identifying and reviewing some of the challenges experienced in Lake County, IL, during the COVID‐19 response may highlight practical solutions for LHDs. Policies and procedures governing resource management during Lake County's COVID‐19 response affected the ability of the Public Health Emergency Operations Center to maintain a common operating picture, provide clear job roles and responsibilities, and prioritize resource application in a dynamic environment. The pace of a global emergency may impact the ability of organisations to conduct these activities, but decision‐makers must obtain the information most likely to impact response efforts. Regardless of the specific resources being applied during an emergency, there will always be a need to identify and review objectives, assess the impact of resource allocation, and adjust resource assignments.

An incentivized scheme for electric vehicle charging demand management

The market share of electric vehicles (EVs) is expected to grow, necessitating infrastructure development to support this expansion. However, scientific literature predominantly focuses on charging infrastructure design, overlooking the importance of pricing strategies that can optimize their utilization. To address this gap, this study presents an integrated incentive scheme aimed at maximizing system utilization by effectively distributing the charging demand across stations. Moreover, a novel concept of Flex Accessible Charging Points (FLEX-ACP) is introduced, specifically designed to enhance accessibility and reduce waiting time for users with disabilities and seniors (UDS). The proposed framework utilizes an optimal charging network configuration, considering the number and locations of charging facilities, and then determines appropriate incentives at each station to minimize total waiting time. The problem is formulated as a bi-level optimization model, which is subsequently transformed into a single-level mixed-integer nonlinear program (MINLP). To solve this program, a combination of heuristic and branch-and-cut algorithms is employed. The developed models are tested through a realistic case study, utilizing real-world data from Salt Lake County in Utah.

Local and Regional Contributions to Tropospheric Ozone Concentrations

The Wasatch Front in Utah, USA is currently a non-attainment area for ozone according to the Environmental Protection Agency’s (EPA) National Ambient Air Quality Standards (NAAQS). Nitrogen oxides (NOx = NO2 + NO) and volatile organic compounds (VOCs) in the presence of sunlight lead to ozone formation in the troposphere. When the rate of oxidant production, defined as the sum of O3 and NO2, is faster than the rate of NOx production, a region is said to be NOx-limited and ozone formation will be limited by the concentration of NOx species in the region. The inverse of this situation makes the region VOC-limited. Knowing if a region is NOx-limited or VOC-limited can aid in generating effective mitigation strategies. Understanding the background or regional contributions to ozone in a region, whether it be from the transport of precursors or of ozone, provides information about the lower limit for ozone concentrations that a region can obtain with regulation of local precursors. In this paper, measured oxidant and NOx concentrations are analyzed from 14 counties in the state of Utah to calculate the regional and local contributions to ozone for each region. This analysis is used to determine the nature of the atmosphere in each county by determining if the region is VOC- or NOx-limited. Furthermore, this analysis is performed for each county for the years 2012 and 2022 to determine if there has been a change in the oxidative nature and quantify the regional and local contributions to ozone over a 10-year period. All studied counties—except for Washington County—in Utah were found to be VOC-limited in 2012. This shifted in 2022 to most counties being either in a transitional state or being NOx-limited. Local contributions to ozone increased in two major counties, Cache and Salt Lake Counties, but decreased in Carbon, Davis, Duchesne, Uinta, Utah, Washington, and Weber Counties. Generally, the regional contributions to oxidant concentrations decreased across the state. A summertime spike in both regional and local contributions to oxidants was seen. Smoke from wildfires was seen to increase the regional contributions to oxidants and shift the local regime to be more NOx-limited.

Green infrastructure inequality in the context of COVID-19: Taking parks and trails as examples

Urban green infrastructures play a critical role in enhancing the well-being of residents, yet their equitable access remains a concern, particularly during the COVID-19 outbreak. There is a lack of knowledge on how people respond to the pandemic regarding the usage of green infrastructure in cities. This paper explores the shifts in visitation to parks and trails, two popular types of green infrastructures in Salt Lake County, Utah, by analyzing the results of a survey conducted during the pandemic. Our conceptualization considers personal and neighborhood level factors, including personal socioeconomic status, existing inequalities of green infrastructures, urban form, and neighborhood conditions. People who reside close to the city center tend to go to parks more often, while those living in urban edges use trails more. Visiting green infrastructures less often is more likely in areas with higher COVID-19 infection rates. The regression results confirm the importance of neighborhood level factors and illustrate the intricate elements influencing people's decisions to visit different green infrastructures during the pandemic, which shows non-linear relationships. Wealthier, white, and younger people seem to enjoy green infrastructures more often, leading to the concern of amplified inequality. Higher COVID-19 cases result in higher demands for green infrastructures, which are not fulfilled during the pandemic, especially for vulnerable communities, leading to spatial exclusion. The findings highlight the importance of smart growth, including compact development, public transit, and pocket parks, in promoting the urban resilience of park and trail visits, as they may provide more opportunities for access and alternatives to green infrastructures even in the context of the pandemic.

Visits to social and community establishments and services by persons experiencing homelessness after shelter decentralization

ABSTRACT Persons experiencing homelessness (PEH) are challenged by inadequate transportation and shelter locations that limit access to employment, healthcare, establishments, social and community services. Surveys were collected from 106 PEH in shelters in Salt Lake County, Utah, to examine the number of social and community establishment and service visits after a centralized downtown shelter location was changed to a scattered site model with three dispersed locations. This study used mixed clustering methods to examine if there was any change in establishment and service visits for PEH based on shelter locations and for PEH at-risk health populations that were older, on Medicaid/Medicare, had disability benefits, or had difficulty walking due to a health condition. Findings suggest that PEH who received disability benefits were significantly less likely to visit social and community establishments and services as frequently post-decentralization. Additional findings suggest that the shelter furthest away from downtown Salt Lake City post-decentralization had a disproportionate number of PEH who did not frequently visit social and community establishments and services. Future shelter relocation models should consider these patterns and potential accessibility issues to ensure PEH needs are being adequately supported.

Epidemiology of SARS-CoV-2 transmission and superspreading in Salt Lake County, Utah, March-May 2020.

Understanding the drivers of SARS-CoV-2 transmission can inform the development of interventions. We evaluated transmission identified by contact tracing investigations between March-May 2020 in Salt Lake County, Utah, to quantify the impact of this intervention and identify risk factors for transmission. RT-PCR positive and untested symptomatic contacts were classified as confirmed and probable secondary case-patients, respectively. We compared the number of case-patients and close contacts generated by different groups, and used logistic regression to evaluate factors associated with transmission. Data were collected on 184 index case-patients and up to six generations of contacts. Of 1,499 close contacts, 374 (25%) were classified as secondary case-patients. Decreased transmission odds were observed for contacts aged <18 years (OR = 0.55 [95% CI: 0.38-0.79]), versus 18-44 years, and for workplace (OR = 0.36 [95% CI: 0.23-0.55]) and social (OR = 0.44 [95% CI: 0.28-0.66]) contacts, versus household contacts. Higher transmission odds were observed for case-patient's spouses than other household contacts (OR = 2.25 [95% CI: 1.52-3.35]). Compared to index case-patients identified in the community, secondary case-patients identified through contract-tracing generated significantly fewer close contacts and secondary case-patients of their own. Transmission was heterogeneous, with 41% of index case-patients generating 81% of directly-linked secondary case-patients. Given sufficient resources and complementary public health measures, contact tracing can contain known chains of SARS-CoV-2 transmission. Transmission is associated with age and exposure setting, and can be highly variable, with a few infections generating a disproportionately high share of onward transmission.

First report of the beech leaf disease nematode Litylenchus crenatae mccannii (Nematoda: Anguinidae) in Michigan.

The North American beech leaf disease (BLD) nematode, Litylenchus crenatae mccannii Handoo, Li, Kantor, Bauchan, McCann, Gabriel, Yu, Reed, Koch, Martin and Burke, 2020, is recognized as a newly emergent nematode species that causes BLD in beech trees (Fagus spp.) in North America (Carta et al. 2020; Kantor et al. 2022a). Since the first report of BLD on American beech (Fagus grandifolia Ehrh) within the Lake County, located at the north-eastern corner of the state of Ohio in 2012 (Carta et al. 2020), the disease has rapidly spread to other US states and a province in Canada (Erwing et al. 2018; Carta et al 2020; Marra and LaMondia 2020; Reed et al 2020; Kantor et al. 2022b). Currently, besides Ohio, this nematode has been reported in Pennsylvania, New York, Connecticut, Massachusetts, Maine, Rhode Island, New Jersey, West Virginia, and Virginia, as well as Ontario, Canada. Different life stages of L. crenatae mccannii were isolated from symptomatic American beech leaves from an isolated natural maple-beech stand in rural Saint Clair Cty., Michigan, US; presenting typical symptoms of beech leaf disease, i.e., swelling and darkening of interveinal leaf tissues. Samples were taken to the Forest Pathology Laboratory at Michigan State University where L. crenatae mccannii presence was confirmed in the leaves after which samples were sent to the Mycology and Nematology Genetic Diversity and Biology Laboratory (USDA-ARS) in Beltsville, Maryland for official confirmation. Nematodes were identified based on morphology and sequence analysis of the internal transcribed spacer (ITS), and the D2D3 region of the 28S large subunit ribosomal DNA. To validate the morphological identification two different ribosomal DNA loci were amplified, sequenced and the phylogenetic relationships were generated. The amplification yielded fragments of 784 and 741 bp flanked by the ITS (GenBank accession no. OP689654) and D2D3 (GenBank accession no. OP689710) primers, respectively. The sequences obtained for the specimens collected in Michigan revealed 100% similarity to L. crenatae mccannii sequences obtained from specimens collected from other geographical areas in the US, and therefore validating the morphological analyses as well. The ITS sequence shared a 99.75% similarity with the subspecies L. crenatae (GenBank accession no. LC383724.1), and 90.53% similarity to L. coprosma Zhao, Davies, Alexander and Riley, 2011 (GU727548.1). While the D2D3 sequences of both L. crenatae subspecies revealed a 100% similarity (versus LC383725.1), they revealed 95.35% similarity to L. coprosma (KY679564.1). Since the first confirmed detection of BLD in June 2022 in St. Clair Cty, BLD has been reported in Oakland and Wayne Ctys (7 reports total across the three counties), suggesting BLD spread in the SE of Michigan. BLD confirmation was based on either physical symptoms (leaf banding), and/or the presence of the beech leaf nematode by morphological or molecular confirmation. The presence of the beech leaf nematode in symptomatic leaves follow the results obtained by Carta et al. (2020) after inoculation of beech seedlings with L. crenatae mccannii. Based on both morphological and molecular analyses the specimens collected in the state of Michigan were identified as L. crenatae mccannii. To our knowledge, this is the first report of this species in conjunction with symptomatic F. grandifolia leaves in this state.

The Impacts of the COVID-19 Pandemic on Youth Violence: Insights from Professional Key Informants

Introduction The COVID-19 pandemic has had drastic effects on youth violence protective and risk factors by isolating many at risk youth. While youth violence is a growing global health problem, there are limited studies exploring youth violence during the COVID-19 pandemic. Lake County in Northwest Indiana presents an opportunity for youth violence research and prevention given its socio-demographic context and its limited youth violence data. This study explored the COVID-19 pandemic’s impacts on youth violence and its risk and protective factors from the perspectives of professional key informants in Lake County, Indiana. Methods This study utilized a descriptive qualitative design inspired by the constructivist grounded theory. We recruited professional key informants through purposive and snowball sampling. Data collection consisted of virtual semi-structured key informant interviews that were audio-recorded and transcribed verbatim. Data analysis consisted of inductive thematic analysis with open line-by-line coding, focused coding in Dedoose, and theme identification. Results A total of six key informants were interviewed, representing diverse youth-serving occupations. These interviews revealed five general themes portraying the impacts of the COVID-19 pandemic on youth violence: mental health impacts on youth; socialization of youth; youth as victims, perpetrators, or witnesses; shifting of learning environments; and parent-child relationships. Key informants observed an increase in less visible types of youth violence, underlying pandemic-induced or-exacerbated youth mental and behavioral health issues, strained parent-child relationships, and the educational marginalization of youth in underserved communities during online learning transitions. Conclusions This study highlighted underserved youth’s vulnerability to the COVID-19 pandemic’s adverse impacts on youth violence experiences, risk, and protective factors. Our findings support the need to prioritize youth during and after crises, to utilize innovative strategies to better reach underserved youth, and to develop ethical and integrated youth violence data systems. Future research should explore youth’s lived experiences with violence throughout the pandemic.

EPH66 Epidemiological Population Study of Sars-Cov-2 in Lake County, Illinois: Contact: Health-Related Quality of Life Assessment

The prospective, longitudinal, community-based CONTACT study aimed to improve our understanding of COVID-19 immunity, and other characteristics related to SARS-CoV-2 long-term, including the assessment of health-related quality of life (HRQoL) at baseline and over time by infection status. Participants living or working in Lake County, IL were recruited between November 2020 and January 2021. At baseline and follow up visits (3-, 6-, and 9-Months-M-), participants self-reported their occupational exposure, COVID-19 vaccination status and provided nasal and blood serum specimens for molecular (RT-PCR) and serologic (IgG) testing to detect current or previous SARS-CoV-2 infection. HRQoL questionnaires EQ-5D-5L were completed online approximately within two weeks post-testing (at 0.5, 3.5, 6.5, and 9.5 months) after results were communicated. EQ-5D-5L information was described and stratified by COVID-19 status at baseline, 3M, 6M and 9M – software: SAS®-v9.4. Data from 1008 participants were analyzed. Participants testing positive to COVID-19 were 56/952, 48/751, 40/693, and 19/654, respectively, at baseline, 3M, 6M, and 9M. Of the five domains of EQ-5D-5L, a higher percentage of participants who tested positive for COVID-19 reported having no anxiety or depression versus those who tested negative: at baseline (55.4% [31/56] vs 50.5% [481/952]); 3M (68.8% [33/48] vs. 56.3% [423/751]); 6M (67.5% [27/40] vs. 56.3% [390/693]); and 9M (73.7% [14/19] vs. 60.4% [395/654]). Median Visual Analogue Scale (VAS) score was at least 2 points higher at all time- points for participants who tested positive except at last visit (baseline: 89.0 vs. 87.0; 3M: 88.0 vs. 86.0; 6M: 87.5 vs. 85.0; 9M: 85.0 vs. 87.0) This analysis provides insight into participant HRQoL burden at enrollment and over time when a positive test to COVID-19 was communicated. At all time-points, anxiety or depression was experienced by more participants who tested negative versus those who didn´t.

Evaluating Social Equity of Transit Accessibility: A Case of Salt Lake County, U.S.

Addressing social equity in public transportation remains a key challenge for many cities and planning organizations. In this study, we examined social equity dimensions of accessibility to light rail transit (LRT) stations in Salt Lake County, U.S., by employing two novel methods. First, we used the two-step floating catchment area (2SFCA) method to examine the interactions between the demand and supply of the public transit service. Second, we developed geospatial models to account for spatial bias in transit equity analysis. Results showed little evidence of inequitable access to LRT stations in Salt Lake County. The accessibility to LRT stations appeared to be generally higher in the downtown and transit catchment areas with a higher concentration of low-income and ethnic minority populations. Furthermore, we found statistically significant associations between higher transit accessibility and households which are not homeowners, and/or do not own a private motor vehicle. Our findings suggest that transit investments in Salt Lake County could leverage substantial transportation accessibility opportunities to achieve an equitable and sustainable future.

Transportation needs and mobility patterns of persons experiencing homelessness following shelter decentralization

The provision and siting of homeless emergency shelters have community-wide implications for addressing the needs of people experiencing homelessness (PEH). In Utah, Salt Lake County’s transition from a large, centralized emergency shelter sited in a free transit zone to a decentralized scattered-site model outside of a no-cost transit zone provided the context to evaluate how transportation access and mobility patterns of PEH were affected as they were displaced from a centralized service network in a downtown core. We conducted 19 in-depth, semi-structured interviews with PEH aged 18 + who were staying in one of three distributed resource centers who had also previously stayed at the former centralized shelter. Thematic analysis of the interviews resulted in three categories, each with distinct sub-categories: 1) Pre-decentralization transportation and mobility, 2) Post-decentralization transportation and mobility, and 3) Recommendations to improve transportation access for PEH, including lowering or eliminating financial barriers to transportation and expanding transit and shuttle van frequency and route radius. Study findings demonstrate that there is a significant need for community planners to collaborate on the siting of homeless shelters to provide more affordable, flexible, and equitable access to transportation networks.

Tech firm births and agglomeration economies: (un)related variety, specialization, and spatial externalities

This paper examined the multi-scalar effects of different types of agglomeration economies, namely, specialization, related variety, unrelated variety, and urbanization economies, on tech firm births in Salt Lake County, Utah, U.S. We found that these agglomeration economies affected tech firm births simultaneously, but their spatial externalities differed across various scales. Specialization and related variety operated at all scales including neighborhood scale while urbanization economies only worked at city-wide scale. Unrelated variety did not affect tech firm births at all scales. Specialization externalities appeared more pronounced at neighborhood scale and its spatial scope was larger than that of related variety. These findings partially explain the recent trend of multiscale clusters of the tech industry and suggest that spatial externalities of agglomeration economies should be understood in different types with a multi-scalar framework. Policymakers and urban planners should highlight this to maintain sustainable development and secure urban success. These findings also imply that distinguishing related and unrelated variety is necessary at neighborhood scale and should not be ignored in local development planning.

Beech Leaf Disease Severity Affects Ectomycorrhizal Colonization and Fungal Taxa Composition.

Beech leaf disease (BLD) is an emerging forest infestation affecting beech trees (Fagus spp.) in the midwestern and northeastern United States and southeastern Canada. BLD is attributed to the newly recognized nematode Litylenchus crenatae subsp. mccannii. First described in Lake County, Ohio, BLD leads to the disfigurement of leaves, canopy loss, and eventual tree mortality. Canopy loss limits photosynthetic capacity, likely impacting tree allocation to belowground carbon storage. Ectomycorrhizal fungi are root symbionts, which rely on the photosynthesis of autotrophs for nutrition and growth. Because BLD limits tree photosynthetic capacity, ECM fungi may receive less carbohydrates when associating with severely affected trees compared with trees without BLD symptoms. We sampled root fragments from cultivated F. grandifolia sourced from two provenances (Michigan and Maine) at two timepoints (fall 2020 and spring 2021) to test whether BLD symptom severity alters colonization by ectomycorrhizal fungi and fungal community composition. The studied trees are part of a long-term beech bark disease resistance plantation at the Holden Arboretum. We sampled from replicates across three levels of BLD symptom severity and compared fungal colonization via visual scoring of ectomycorrhizal root tip abundance. Effects of BLD on fungal communities were determined through high-throughput sequencing. We found that ectomycorrhizal root tip abundance was significantly reduced on the roots of individuals of the poor canopy condition resulting from BLD, but only in the fall 2020 collection. We found significantly more ectomycorrhizal root tips from root fragments collected in fall 2020 than in spring 2021, suggesting a seasonal effect. Community composition of ectomycorrhizal fungi was not impacted by tree condition but did vary between provenances. We found significant species level responses of ectomycorrhizal fungi between levels of both provenance and tree condition. Of the taxa analyzed, two zOTUs had significantly lower abundance in high-symptomatology trees compared with low-symptomatology trees. These results provide the first indication of a belowground effect of BLD on ectomycorrhizal fungi and contribute further evidence to the role of these root symbionts in studies of tree disease and forest pathology.

188 Feasibility and Anticipated Acceptability of Community Health Worker-facilitated HPV Self-sampling

OBJECTIVES/GOALS: This community-engaged study explores Community Health Workers (CHWs), perspectives on i) barriers to cervical cancer screening and ii) the acceptability and feasibility of CHW-facilitated HPV self-sampling as a means of reducing existing cervical cancer disparities. METHODS/STUDY POPULATION: Semi-structured in-depth interviews were conducted with 15 CHWs in 2021 to gain insights into barriers to cervical cancer screening and the acceptability and feasibility of CHW-facilitated self sampling in their communities. Recruitment began in Lake County then expanded to East Chicago after initial interviews revealed that some community members seek care in this area. An IRB approved email was sent out to community partners’ mailing lists inviting CHWs to join a 30–60 minute interview. Participants received a $25 electronic gift card as compensation. Interviews were audio recorded, transcribed and then analyzed by the study team, using a combination of inductive and deductive coding. The Socio-Ecological Model was used as a guiding framework to analyze multilevel barriers and facilitators to screening. RESULTS/ANTICIPATED RESULTS: CHW-facilitated HPV self-sampling shows promise of mitigating (without eliminating) several existing barriers to cervical cancer screening, with six key considerations. Privacy (for most), time saved, and comfort were perceived to be major facilitators for acceptability, with concerns about the novelty of this approach, trust in provider (as opposed to CHW) expertise, and lack of privacy at home (for some) emerging as barriers. In terms of feasibility, synergies with existing CHW work, and some community members’ prior experience with self-sampling were found to be facilitators, with CHW’s self-efficacy in providing adequate support and limited time constituting areas of concerns for feasibility. Considerations for adoption included CHW training, gender concordance, safety and respect, among others. DISCUSSION/SIGNIFICANCE: In light of national calls to engage CHWs in screening delivery and leverage self-sampling, this study provides CHW perspectives as key stakeholders on a screening model that directly engages them, providing insights that can inform successful implementation to increase screening in Lake County and similarly underserved contexts in the US.