Louisiana Residents Research Articles

P-2062. COVID-19 XBB.1.5-adapted Vaccine Uptake in Immunocompromised Individuals Using Tokenized State Vaccine Registries

Abstract Background Immunocompromised individuals experience a disproportionate burden of COVID-19-associated hospitalization and death. COVID-19 vaccine uptake has declined over time. We evaluated XBB.1.5-adapted vaccine uptake, regardless of brand, during the 2023-2024 season among immunocompromised persons using data from two large state vaccine registries. Methods Individuals with continuous pharmacy and medical enrollment (≥6 months for children < 18 years, ≥12 months for adults ≥18 years) in insurance plans contributing to HealthVerity and residency in either California or Louisiana as of September 11, 2023 (the date XBB.1.5-adapted vaccines were authorized or approved) were selected. A prior dose of any COVID-19 vaccine was required. Persons were defined as immunocompromised if they had one or more of the following conditions as defined by the Centers for Disease Control and Prevention: HIV/AIDS, hematologic malignancy, solid organ or bone marrow transplant, primary immunodeficiency, or recent use of immunosuppressive medications. XBB.1.5-adapted vaccine uptake was assessed using de-identified records from state vaccine registries in California and Louisiana that were linked via tokenization with claims data. Results A total of 321,896 California residents (median age 55 years; 57% female) and 43,250 Louisiana residents (median age 45 years; 64% female) with at least one immunocompromising condition were identified. In both states, the most common immunocompromising condition was use of immunosuppressive medications (78% California and 85% Louisiana). By the end of March 2024, 19% and 6% of immunocompromised individuals in California and Louisiana, respectively, received an XBB.1.5-adapted vaccine. Uptake was generally similar regardless of immunocompromising condition (Table 1). Conclusion During the 2023-2024 season, COVID-19 vaccine uptake in immunocompromised persons was low, with fewer than 20% of this high-risk population receiving the XBB.1.5-adapted vaccine. Enhanced efforts to increase COVID-19 vaccine uptake in this vulnerable population are urgently needed. Disclosures Matthew A. Brouillette, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Farid L. Khan, MPH, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Santiago M.C. Lopez, MD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Kathleen M. Andersen, PhD MSc, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company) Tiange Yu, MS, Pfizer Inc.: Employee of Genesis Research Group which has received consulting fees from Pfizer Inc. Benjamin T. Carter, PhD, Pfizer Inc.: Employee of Genesis Research Group which has received consulting fees from Pfizer Inc. John M. McLaughlin, PhD, Pfizer: Employee|Pfizer: Stocks/Bonds (Public Company) Leah McGrath, PhD, Pfizer Inc.: Employee|Pfizer Inc.: Stocks/Bonds (Public Company)

The Impact of Vacant and Abandoned Property on Health and Well-Being: A Qualitative Inquiry

This qualitative study explored the role of neglected properties and neighborhood environment characteristics on a sample of New Orleans, Louisiana residents’ health and well-being, sense of community, sense of safety, and civic engagement. We hypothesized that residents would identify conditions of their neighborhood's physical environment, including neglected properties, as one factor that impacted their health and other aspects of well-being. Seventy-four (N = 74) participants, including women, men, youth, young adults, and community leaders, took part in 11 focus groups (n = 51) and 23 key informant interviews. Thematic content analysis through inductive and deductive coding cycles of interview transcripts revealed five main categories related to urban neighborhood-built and social environments: 1) health and well-being, 2) sense of community, 3) sense of safety, 4) civic engagement, and 5) youth and family violence. Ten themes were developed and included, for example, the role of neighborhoods in delineating access to health-promoting characteristics and resources; the role of neighborhood social networks as crime prevention strategies; resident-led decision-making in neighborhood improvements; the negative impact of neglected properties; and the role of the local government in improving physical infrastructure. These findings affirm that residents were aware of and impacted by the cyclical nature of built environment neglect on health and well-being, community violence, neighborhood cohesion, civic engagement, and youth violence. Participants recommended improving neighborhood conditions to shift resident mindsets about the health of neighborhoods, reduce violence, and improve quality of life.

Impact of rural location on receipt of standard of care treatment and survival for locally advanced bladder cancer in Louisiana.

We aim to determine the effect of region of residence (urban vs. rural) on the odds of receiving standard of care treatment for locally advanced BCa in Louisiana and its impact on survival outcomes. Using the Louisiana Tumor Registry, we identified American Joint Committee on Cancer (AJCC) stage II or III, BCa diagnoses in Louisiana residents between 2010 and 2020. Treatment received was classified as standard or non-standard of care according to American Urological Association (AUA) guidelines and location of residence was determined using Rural Urban Commuting Area-Tract-level 2010 (RUCA). Multivariable logistic regression analyses and multivariate cox proportional hazard analyses were performed. Of 983 eligible patients, 85.6% (841/983) lived in urban areas. Overall, only 37.5% received standard-of-care (SOC) for the definitive management of locally advanced bladder cancer. Individuals living in rural areas (OR 0.53, 95% CI: 0.31-0.91, p = 0.02) were less likely to receive standard of care treatment. Both rural residence and receipt of non-standard of care therapy were associated with an increased risk of bladder cancer-specific (adj HR 1.53, 95% CI: 1.09-2.14, p = 0.01 and adj HR: 1.85, 95% CI: 1.43-2.39, <0.0001) and overall mortality (adj HR: 1.28, 95% CI: 1.01-1.61, p = 0.04 and adj HR: 1.73 95% CI: 1.44-2.07, p < 0.0001). Most patients with locally advanced bladder cancer in Louisiana do not receive SOC therapy. Individuals living in rural locations are more likely to receive non-standard of care therapy than individuals in urban areas. Nonstandard of care treatment and rural residence are both associated with worse survival outcomes for Louisiana residents with locally advanced bladder cancer.

Hurricane season hindsight 2020: Applying the IDEA model toward local tropical cyclone forecasts.

Hurricane Laura began as a disorganized tropical depression in August 2020. Early forecast guidance showed that the tropical cyclone could either completely dissipate or strengthen to a major hurricane as it approached the United States Gulf Coast. While this uncertainty was known by meteorologists, it was not necessarily communicated to the public in a direct manner. As it turned out, the worst-case scenario was the correct one. The tropical depression rapidly intensified and made landfall near Cameron, Louisiana, with sustained winds of 150 mph, making Laura a Category 4 hurricane on the Saffir-Simpson scale. Laura's rapid intensification caught some people off guard. Ideally, weather forecasts would have begun warning Louisiana residents to prepare for the possibility of a devastating hurricane in the early stages of tropical cyclone development. No one is suggesting that meteorologists did anything wrong. However, with the benefit of hindsight and decades of scholarly research in risk communication, we can speculate how an ideal forecast would have been written. This paper demonstrates that there are some simple considerations that could be made that might better alert the public to future hurricane worst-case scenarios, even in uncertain situations.

Persisting Anxiety: The Duration of Emotions during the COVID-19 Pandemic

Abstract Events and leaders can generate feelings of anxiety that shape political attitudes and behavior in the short run. Yet, threats are often ephemeral, and existing literature does not show whether anxiety or its effects fade as easily as they rise. We address this gap by examining the persistence of anxiety toward the health and economic risks associated with the COVID-19 pandemic. Furthermore, we examine the duration of anxiety’s role in information gathering as well as the role of information search on continued experiences of anxiety. To address these questions, we use a five-wave panel survey of a representative sample of adult residents of Louisiana, a state where the COVID-19 pandemic hit particularly hard but with uneven health and economic impacts. We find evidence confirming reinforcement of anxiety, in which feeling anxious at one point in time is associated with anxiety at subsequent points independent of continued threat exposure and individual heterogeneity in the propensity to feel anxious. We also find modest evidence that biased information seeking behavior accounts for some of this reinforcement. Additionally, we find mixed evidence for the persistence of anxiety’s effects on political attitudes even after threat exposure subsides.

News from Home: How Local Media Shapes Climate Change Attitudes

Abstract Highlighting the local impacts of climate change has the potential to increase the public’s awareness of and engagement with climate change. However, information about local impacts is only effective when delivered by trusted sources such as copartisan political leaders. Is information about climate change conveyed by local media sources similarly beneficial? We argue that local media are well positioned to communicate the local implications of climate change, thereby enhancing the public’s risk perceptions of climate change and willingness to take climate action. We further hypothesize that climate coverage by local media, the media type that is more trusted across party lines, will have a significant influence on Republicans’ climate attitudes. Using the case of Louisiana, we first demonstrate that local and national newspapers cover climate change in substantially different ways, with local media more consistently focused on local impacts. Our survey experiment of Louisiana residents reveals that Republicans viewed the coverage of a hurricane in the region more positively when it came from a local newspaper rather than a national newspaper. Furthermore, local newspapers’ climate coverage increased Republicans’ willingness to take action to mitigate climate change. These results provide insights into the effective communication of climate change to the public and the role of local media in mitigating partisan polarization.

Information Needs of Coastal Residents in Louisiana, U.S.A.: Implications for Risk Communication

Information Needs of Coastal Residents in Louisiana, U.S.A.: Implications for Risk Communication

Modeling behavioral economic strategies in social marketing messages to promote vegetable consumption to low-resource Louisiana residents: A conjoint analysis.

Behavioral economic strategies implemented within social marketing campaigns improve eating behavior. To identify which behavioral economic (BE) strategies in social marketing messages, i.e., messengers, norms, and commitments, will promote low-income Louisiana (LA) residents to add more vegetables to meals. Full profile traditional conjoint analysis survey with single concept ratings. Purposive sample of low-resource LA residents (N = 213) SETTING: Online survey INTERVENTION: Participants rated randomized concepts that featured a messenger and a message. Ratings (1-9) of likelihood to add vegetables to meals. A model of ratings was generated using mixed-effects multiple regression, which accounted for repeated measurement of participants. Interactions of variables and covariates were modeled. There was significant variation in the main effect of the messenger variable (P = 0.02) and the main effect of the message variable (P = 0.008). Pairwise comparisons demonstrated differences between friend (mean = 6.80) and mother (mean = 7.06, P = 0.03) as well as friend and normal weight doctor (mean = 7.03, P = 0.04). Pairwise comparisons demonstrated differences between descriptive norm (mean = 6.79) and grocery list commitment (mean = 7.02, P = 0.05) along with descriptive norm and injunctive norm (mean = 6.98, P = 0.04). Covariate models demonstrated main effects of race (P = 0.006) and gender (P = 0.0001). There was significant variation in the message variable and frequency of vegetable intake interaction (P = 0.01). Both message and messenger variables predicted the likelihood to add vegetables to meals. Race and gender influenced ratings to add vegetables. As reported vegetable consumption increased, behavioral economic messages improved the likelihood to add vegetables to meals. Behavioral economic approaches are well-suited to social marketing messages that aim to promote healthy eating behavior in low-income LA residents.

Increasing Participation in a TelePrEP Program for Sexual and Gender Minority Adolescents and Young Adults in Louisiana: Protocol for an SMS Text Messaging-Based Chatbot.

Sexual and gender minority (SGM) adolescents and young adults (AYAs) are at increased risk of HIV infection, particularly in the Southern United States. Despite the availability of effective biomedical prevention strategies, such as pre-exposure prophylaxis (PrEP), access and uptake remain low among SGM AYAs. In response, the Louisiana Department of Health initiated the LA TelePrEP Program, which leverages the power of telemedicine to connect Louisiana residents to PrEP. A virtual TelePrEP Navigator guides users through the enrollment process, answers questions, schedules appointments, and facilitates lab testing and medication delivery. To increase the participation of SGM AYAs in the program, the TelePrEP program partnered with researchers to develop a chatbot that would facilitate access to the program and support navigator functions. Chatbots are capable of carrying out many functions that reduce employee workload, and despite their successful use in health care and public health, they are relatively new to HIV prevention. In this paper, we describe the iterative and community-engaged process that we used to develop an SMS text messaging-based chatbot tailored to SGM AYAs that would support navigator functions and disseminate PrEP-related information. Our process was comprised of 2 phases: conceptualization and development. In the conceptualization phase, aspects of navigator responsibilities, program logistics, and user interactions to prioritize in chatbot programming (eg, scheduling appointments and answering questions) were identified. We also selected a commercially available chatbot platform that could execute these functions and could be programmed with minimal coding experience. In the development phase, we engaged Department of Health staff and SGM AYAs within our professional and personal networks. Five different rounds of testing were conducted with various groups to evaluate each iteration of the chatbot. After each iteration of the testing process, the research team met to discuss feedback, guide the programmer on incorporating modifications, and re-evaluate the chatbot's functionality. Through our highly collaborative and community-engaged process, a rule-based chatbot with artificial intelligence components was successfully created. We gained important knowledge that could advance future chatbot development efforts for HIV prevention. Key to the PrEPBot's success was resolving issues that hampered the user experience, like asking unnecessary questions, responding too quickly, and misunderstanding user input. HIV prevention researchers can feasibly and efficiently program a rule-based chatbot with the assistance of commercially available tools. Our iterative process of engaging researchers, program personnel, and different subgroups of SGM AYAs to obtain input was key to successful chatbot development. If the results of this pilot trial show that the chatbot is feasible and acceptable to SGM AYAs, future HIV researchers and practitioners could consider incorporating chatbots as part of their programs. PRR1-10.2196/42983.

MP22-02 THE IMPACT OF RURAL RESIDENCY ON THE TREATMENT AND OUTCOMES OF LOCALLY INVASIVE/ADVANCED BLADDER CANCER IN LOUISIANA

You have accessJournal of UrologyCME1 Apr 2023MP22-02 THE IMPACT OF RURAL RESIDENCY ON THE TREATMENT AND OUTCOMES OF LOCALLY INVASIVE/ADVANCED BLADDER CANCER IN LOUISIANA Megan Escott, Tingting Li, Mei-Chin Hsieh, Scott Delacroix, Jessie Gills, Xiao-Cheng Wu, and Mary Westerman Megan EscottMegan Escott More articles by this author , Tingting LiTingting Li More articles by this author , Mei-Chin HsiehMei-Chin Hsieh More articles by this author , Scott DelacroixScott Delacroix More articles by this author , Jessie GillsJessie Gills More articles by this author , Xiao-Cheng WuXiao-Cheng Wu More articles by this author , and Mary WestermanMary Westerman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003247.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: A later stage at diagnosis, gender, and race are independent predictors of bladder cancer-specific survival. There remains a need, however, to investigate additional contributors. We investigated the effect of urban and rural residency on a patient’s likelihood to receive standard of care in Louisiana and its impact on cancer-specific and overall survival. METHODS: Using the Louisiana Tumor Registry, we identified microscopically confirmed AJCC stage II – III bladder cancer diagnoses between 2014 and 2018. Multivariable logistic regression, Kaplan-Meier method, and Multivariate Cox proportional hazard analysis was performed. RESULTS: We identified 704 patients, with 75% having AJCC stage two disease. 598 (85%) patients lived in urban settings and 106 (15%) patients lived in rural settings. After controlling for race, socioeconomic status, and insurance coverage, there was no significant difference in the probability of urban and rural residents receiving the standard of care for definitive management. However, rural residency was independently associated with an increased risk of cancer-specific mortality (Figure 1). The median overall survival for residents of urban areas was 27 months (95% CI [23, 33]) compared to 13 months (95% CI [10, 20]) for residents of rural areas (Figure 2). CONCLUSIONS: A recent study using national census data called for further epidemiologic investigations after finding that patients with bladder cancer who lived in rural areas had significantly higher overall mortality and marginally increased cancer-specific mortality. Despite all Louisiana residents receiving the standard of care for definitive management of locally invasive bladder cancer, rural patients still had increased risks of cancer-specific and overall mortality after controlling for several demographic factors, only highlighting the need for continued investigation into disparities in bladder cancer outcomes. Source of Funding: NCI’s Surveillance, Epidemiology, End Result (SEER): HHSN261201800007I/HHSN26100002. CDC’s National Program Cancer Registries (NPCR): NU58DP006332 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e295 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Megan Escott More articles by this author Tingting Li More articles by this author Mei-Chin Hsieh More articles by this author Scott Delacroix More articles by this author Jessie Gills More articles by this author Xiao-Cheng Wu More articles by this author Mary Westerman More articles by this author Expand All Advertisement PDF downloadLoading ...

Associations of COVID-19 Hospitalizations, ICU Admissions, and Mortality with Black and White Race and Their Mediation by Air Pollution and Other Risk Factors in the Louisiana Industrial Corridor, March 2020-August 2021.

Louisiana ranks among the bottom five states for air pollution and mortality. Our objective was to investigate associations between race and Coronavirus Disease 2019 (COVID-19) hospitalizations, intensive care unit (ICU) admissions, and mortality over time and determine which air pollutants and other characteristics may mediate COVID-19-associated outcomes. In our cross-sectional study, we analyzed hospitalizations, ICU admissions, and mortality among positive SARS-CoV-2 cases within a healthcare system around the Louisiana Industrial Corridor over four waves of the pandemic from 1 March 2020 to 31 August 2021. Associations between race and each outcome were tested, and multiple mediation analysis was performed to test if other demographic, socioeconomic, or air pollution variables mediate the race-outcome relationships after adjusting for all available confounders. Race was associated with each outcome over the study duration and during most waves. Early in the pandemic, hospitalization, ICU admission, and mortality rates were greater among Black patients, but as the pandemic progressed, these rates became greater in White patients. However, Black patients were disproportionately represented in these measures. Our findings imply that air pollution might contribute to the disproportionate share of COVID-19 hospitalizations and mortality among Black residents in Louisiana.

Indigenous Removal and (Un)Recognition in the Plantationocene: Documenting Louisiana's Rising Waters

ABSTRACT: In the 2012 documentary, My Louisiana Love , United Houma Nation (UHN) artist and activist Monique Verdin shares maps that display how her tribe was forced into the wetlands of south Louisiana by settler colonialism (5:40-6:00). In Can't Stop the Water (2014), a documentary about the Isle de Jean Charles Band of Biloxi-Chitimacha-Choctaw (BCC), the tribe dubbed America's "first climate refugees" by The New York Times , Chief Albert Naquin describes his community as made up of "refugees from the Trail of Tears" (4:29-4:35). The issues of subsidence, seawater intrusion from canals dug by gas and oil companies, and rising waters impact all of south Louisiana's residents, yet the state's coastal Indigenous peoples whose cultures and economies are directly tied to the diminishing land are most immediately affected. My Louisiana Love and Can't Stop the Water address these issues within the Indigenous communities at the center of their narratives, communities with a legacy of displacement directly resulting from Plantationocene practices who are forced to consider relocation again in the near future. These documentaries unblinkingly indict the petroleum industry, underscoring the ways it has participated in the destruction of the Gulf Coast with little involvement in its restoration. This article analyzes the efficacy of the films in portraying the challenges faced by their communities and the activism each work depicts and engenders, as well as illuminates the role that southeastern Indigenous Louisianans have played and continue to play in the Plantationocene.

Indigenous Removal and (Un)Recognition in the Plantationocene: Documenting Louisiana's Rising Waters

ABSTRACT: In the 2012 documentary, My Louisiana Love , United Houma Nation (UHN) artist and activist Monique Verdin shares maps that display how her tribe was forced into the wetlands of south Louisiana by settler colonialism (5:40-6:00). In Can't Stop the Water (2014), a documentary about the Isle de Jean Charles Band of Biloxi-Chitimacha-Choctaw (BCC), the tribe dubbed America's "first climate refugees" by The New York Times , Chief Albert Naquin describes his community as made up of "refugees from the Trail of Tears" (4:29-4:35). The issues of subsidence, seawater intrusion from canals dug by gas and oil companies, and rising waters impact all of south Louisiana's residents, yet the state's coastal Indigenous peoples whose cultures and economies are directly tied to the diminishing land are most immediately affected. My Louisiana Love and Can't Stop the Water address these issues within the Indigenous communities at the center of their narratives, communities with a legacy of displacement directly resulting from Plantationocene practices who are forced to consider relocation again in the near future. These documentaries unblinkingly indict the petroleum industry, underscoring the ways it has participated in the destruction of the Gulf Coast with little involvement in its restoration. This article analyzes the efficacy of the films in portraying the challenges faced by their communities and the activism each work depicts and engenders, as well as illuminates the role that southeastern Indigenous Louisianans have played and continue to play in the Plantationocene.

What Is Refugee Resilience? Reframing Survival under Environmental Sacrifice

What Is Refugee Resilience?Reframing Survival under Environmental Sacrifice Simi Kang (bio) Introduction When Hurricane Ida struck southeast Louisiana on the sixteenth anniversary of Katrina's landfall, the region was deep in crisis. At the time, both state and community resources were already stretched thin. Severe and consistent COVID-19 spikes, decades of disaster, and a sociopolitical landscape whose bedrock of environmental racism and expendability made it nearly impossible for racialized residents to prepare for, let alone manage, yet another crisis. From my temporary home in Coast Salish territories,1 itself blanked in wildfire smoke, I tried to contact the community-based organizations (CBOs) I work with as Ida overwhelmed coast-dependent communities within and outside of the Army Corps' levee system. For four days, I couldn't reach anyone. Forced to watch Bvlbancha2,3-based media reports on the storm's violence—tabulating potential fatalities, road closures, and structural losses—I was left to hope that folks I knew and cared about were able to navigate and survive this latest 500-year storm.4 In those four days, some vulnerable coastal residents who didn't receive mandatory evacuation orders (e.g., in parts of the West Bank of Plaquemines Parish5) were forced to manage a 500-year storm with few resources.6 Others were struggling to find alternative shelter that was safe and affordable. Some, like many commercial fisherfolk, made themselves acutely vulnerable to save their businesses, staying on their boats and steering into the harsh winds. Their families could not [End Page 43] reach them to determine their safety. As cell service was restored in the days following Ida, I was told by many that, as with Katrina, no one was coming to help in hurricane's immediate aftermath.7 But even two and three weeks into power and water outages and in intense heat, federal agencies were still mostly silent along the coast. What "help" there was proved aggressively insufficient: a few hundred homes received state help putting tarps on their roofs, and base camps were erected by the National Guard to serve as temporary shelter, but, according to locals, they were used mostly for laundry because most folks didn't want to leave their homes unattended. Sandy Nguyen, the executive director of Coastal Communities Consulting, Inc. (CCC), an all-women-of-color-run nonprofit that supports Vietnamese and Cambodian American fishing-dependent families, made this clear. On a call, she told me, "The [fisherfolk] know how to deal with hurricanes... We have to do it ourselves—no one else is coming to help." After talking more about how difficult it would be to get damaged boats out of the bayous and what it would take for deckhands to find work when their bosses were dealing with repairs, Sandy got mad. She entreated, "We are resilient, Simi. But how much longer can they expect us to be resilient? You can only bend so much before you break." She was pointing to prior conversations where we discussed how the idea of resilience has been weaponized against Southeast Asian American commercial fishing families and their neighbors. If fisherfolk and other racialized residents were expected to be resilient—or to withstand disaster after disaster without reliable, timely, or sufficient support and other infrastructure to make healthy lives—now we knew it didn't just mean that no one was coming now; it meant that no one was coming in the future, either. I begin with a recent disaster and the dearth of governmental/structural support it garnered to highlight how the term "resilience" is, first, used differently by structurally underserved communities, politicians, and policymakers and, second, how the latter two deploy the term to relegate some communities to the role of "necessary sacrifice" in the longue durée disaster that constitutes southeast Louisiana. As a feminist ethnographer, I am interested in how Vietnamese American residents of southeast Louisiana are made structurally expendable at the intersections of race, environmental injustice, and immigration policy. For me, these intersections are productively animated through the racializing formation I call refugee resilience, the central conceit and analytic of this article. A deeply violent approach to disaster policy, refugee resilience demands that Vietnamese Americans...

Knowledge, attitudes, and practices towards mosquito control and used vehicle tire dumping by median household income, in metropolitan New Orleans, Louisiana.

Discarded vehicle tires are an important artificial habitat for the larvae of many container-breeding mosquito species worldwide, including in the United States. Unmanaged discarded vehicle tires create health, environmental and social costs, and with budget and staffing constraints, effective management of discarded used vehicle tires a mosquito larval habitat depends in part on the knowledge, attitude, and practices (KAP) of community residents. This study aims to examine the knowledge, attitude and practices of New Orleans, Louisiana residents toward illegally discarded vehicle tires, and larval mosquito control. A descriptive cross-sectional design study was used where 422 households were selected using a two-stage cluster random sampling procedure in New Orleans, Louisiana. Heads of households or a person aged 18 years or older self-administered the survey. The questionnaire comprised five parts: screening, tire sightings, preferred communication method, knowledge, attitude and precautionary measures against mosquito control, disease risk and illegal discarding. We then statistically compared above and below median income household responses to identify likely causes of detected differences. The data were analyzed using ordinal regression models via IBM SPSS statistics V.26.0. Statistical significance was set at p<0.05. Out of 290 responding households, 95.5% strongly agree or agree that mosquitoes can spread serious diseases like West Nile, Zika or Dengue. Only 2.3% of the sample had high knowledge of illegally discarded tires dumping and mosquito larval control. Those employed were 1.0 times more likely to possess good knowledge than the unemployed (p<0.001). Despite low knowledge levels regarding mosquito breeding and polluted water in discarded tires, 29.9% of respondents had positive attitude and 20.5% reported sufficient practices. Among the socio-demographic variables, only home ownership and being employed were predictors of knowledge and attitude towards mosquito breeding in illegally discarded tires (p<0.05). Despite the observed increasing number of illegally discarded vehicle tires in New Orleans, the knowledge of people about illegal tire dumping and their associated risk factors as suitable larval habitants was low. Therefore, there is a need for developing community-based and place-based tailored sensitization campaigns to prevent illegal used tire dumping, and larval control.

Perceived environmental threats, place attachment, and natural resource employment: predicting willingness to move from a threatened coastline

ABSTRACT This study examines the factors predicting willingness to move, in the face of environmental threats, among residents of southeast Louisiana, a region prone to disasters and facing slower moving threats, such as coastal erosion and environmental pollution. Using household-level survey data, I test the relationships that the number of perceived threats to one’s home, place attachment, and industry of employment have with willingness to move. Results indicate that the number of perceived threats is positively related with willingness to move, and place attachment and ties to the fishing industry are negatively related with willingness to move. Drawing on vulnerability and resilience paradigms, I conceptualize the connection between perceived threats and willingness to move as an adaptive capacity, and I conceptualize the connections between place attachment and ties to the fishing industry with unwillingness to move as a form of vulnerability. These analyses provide insight into an issue facing more and more Americans, elective climate-change-induced migration.

Analysis of the Determinants of Health Outcomes among Louisiana’s Residents: A Test of the Precede-Proceed Theoretical Framework

The purpose of this study is to analyze the determinants of health outcomes among residents of the State of Louisiana following the implementation of the Patient Protection and Affordable Care Act (ACA) between 2011 and 2021 by applying the behavioral change approach’s PRECEDE-PROCEED Model as well as using secondary sources of data to inform public policy. The study has made use of two dependent variables (i.e. mortality and morbidity), and the following independent variables such as Health behaviors, Clinical care, coupled with Social and economic factors, and Physical Environment, while lack of access to health insurance and access to primary care physician were treated as control variables. The study revealed that for every 1% increase in bad health behaviors among residents of Louisiana, morbidity rate increases by 98.7%, while mortality rate increases by 59.7%. The study has further revealed that for every 1% increase in the percentage of uninsured adults among the population of Louisiana, the State’s mortality rate is likely to increase by 0.402 or 40.2%. Furthermore, the study revealed that, for every 1% increase in the access to primary care physician among the population of Louisiana, the State’s mortality rate, and morbidity rate are likely to decrease by -0.426 or 42.6%, and -0.602 or 60.2%, respectively. The study recommends that government and policy makers should enforce all existing laws and policies toward protecting quality physical environment for air, natural resources, and the water bodies—rivers, oceans, etc. to save the lives of the people. All regulations on pollution should be intensified. Lastly, the creation of more infrastructure by policymakers, and all stakeholders will go a long way to help bridge the social &amp; economic gap in the State of Louisiana. Keywords: Clinical care, Healthcare, Precede-Proceed, Morbidity, Mortality, Insurance, Physicians, Primary care, Behaviors, Environment, and Health DOI: 10.7176/PPAR/12-6-06 Publication date: August 31 st 2022

Geographic disparities in disruptions to abortion care in Louisiana at the onset of the COVID-19 pandemic

ObjectivesPrior research identified a significant decline in the number of abortions in Louisiana at the onset of the COVID-19 pandemic, as well as increases in second-trimester abortions and decreases in medication abortions. This study examines how service disruptions in particular areas of the state disparately affected access to abortion care based on geography. Study DesignWe collected monthly service data from Louisiana's abortion clinics (January 2018–May 2020) and conducted mystery client calls to determine whether clinics were scheduling appointments at pandemic onset (April–May 2020). We used segmented regression to assess whether service disruptions modified the main pandemic effects on the number, timing, and type of abortions using stratified models and interaction terms. Additionally, we calculated the median distance that Louisiana residents traveled to the clinic where they obtained care. ResultsFor residents whose closest clinic was consistently scheduling appointments at the onset of the pandemic, the number of monthly abortions did not change (IRR = 1.07, 95% CI: 0.84–1.36). For those whose closest clinic services were disrupted, the number of monthly abortions decreased by 46% (IRR = 0.54, 95% CI: 0.45–0.65). Similarly, increases in second-trimester abortions and decreases in medication abortions were concentrated in areas where residents experienced service disruptions (AOR = 2.25, 95% CI: 1.21–4.56 and AOR = 0.59, 95% CI: 0.29–0.87, respectively) and were not seen elsewhere in the state. ConclusionChanges in the number, timing and type of abortions were concentrated among residents in particular areas of Louisiana. The early stages of the COVID-19 pandemic exacerbated geographic disparities in access to abortion care. ImplicationsDisruptions in services at the beginning of the COVID-19 pandemic in Louisiana meaningfully affected pregnant people's ability to obtain an abortion at their nearest clinic. These findings reinforce the importance of developing mechanisms to support pregnant people during emergency situations when traveling to a nearby clinic is no longer possible.

Disasters, Displacement, and Housing Instability: Estimating Time to Stable Housing 13 Years after Hurricane Katrina

Abstract Catastrophic disasters disrupt the structural and social aspects of housing, which can lead to varying lengths of displacement and housing instability for affected residents. Stable housing is a critical aspect of postdisaster recovery, which makes it important to understand how much time passes before displaced residents are able to find stable housing. Using the Gulf Coast Child and Family Health Study, a longitudinal cohort of Mississippi and Louisiana residents exposed to Hurricane Katrina (n = 1079), we describe patterns of stable housing by identifying protective and prohibitive factors that affect time to stable housing in the 13 years following the storm. Survival analyses reveal that median time to stable housing was 1082 days—over 3 years after Katrina. Age, housing tenure, marital status, income, and social support each independently affected time to stable housing. Findings suggest that postdisaster housing instability is similar to other forms of housing instability, including eviction, frequent moves, and homelessness. Significance Statement Climate change is expected to increase gradual-onset events like sea level rise, as well as the frequency and intensity of acute disasters like hurricanes. Such events when coupled with population growth, coastline development, and increasing inequality will lead to high levels of displacement and housing instability. Using longitudinal data, we wanted to understand how much time passed until residents who were displaced by Hurricane Katrina were able to find permanent and stable housing and identify factors that either prolonged or accelerated respondents’ time to stable housing. Addressing this gap can help to improve resident recovery and create targeted postdisaster housing policy, especially as displacement from disasters becomes increasingly common among those living in regions susceptible to the effects of climate change.

Responding to flood risk in Louisiana: the roles of place attachment, emotions, and location

Drawing from protection motivation theory (PMT), we examined how place attachment and negative emotions, alongside threat and coping appraisals, personal experiences, and demographic characteristics, relate to behavioral intentions to mitigate exposure to flood risks in southern Louisiana. We administered a statewide, representative telephone survey to 807 Louisiana residents, oversampling residents living in southern and coastal parishes particularly vulnerable to flood risk. While the results showed no difference depending on participants’ location in the state, there were strong effects of coping appraisals on individuals’ intentions to mitigate their exposure to flood risk, consistent with prior PMT findings. The addition of place attachment to standard PMT variables revealed a nuanced relationship with behavioral intentions. Results show that participants’ place attachment decreased the effects of threat and coping appraisals on some behavioral intentions, such as moving out of the state, while posing no significant effect of threat and coping appraisals on other intentions, such as supporting flood risk mitigation policies. Feeling negative emotions increased the likelihood of participants’ indicating a willingness to move or elevate their home, among other actions. While this study supports the consistency of threat and coping appraisals to predict discrete behavioral intentions, the results also provide insight that may be critical for risk communication initiatives in Louisiana. Namely, individuals with high levels of place attachment may be less willing to leave their community but more willing to engage in behaviors that enhance community resilience, although the more negative emotions they feel, the more willing they may be to take more drastic measures.