Metropolitan Boston Research Articles

Socioeconomic and Demographic Factors Contributing to COVID-19-Related Delays and Reductions in Primary Retinal Detachment Repair in a US Hot Spot.

This work evaluates demographic and socioeconomic predictors of delayed care for rhegmatogenous retinal detachments (RRDs) during the spring 2020 COVID-19 shutdown in a US hot spot. This multicenter, retrospective, case-control study took place in 3 academic vitreoretinal practices in metropolitan Boston. Consecutive patients treated for RRD during the COVID-19 state of emergency were compared with patients treated during the same period in 2018 and 2019. The primary outcome was macula status for RRD. Secondary outcomes included visual acuity, symptom duration, proportion with proliferative vitreoretinopathy, time to procedure, method of repair, and patient demographics. The total number of acute RRD decreased by 13.7% from 2018 to 2020 and 17.2% from 2019 to 2020. Symptom duration was significantly longer in 2020 than 2018 and 2019 (median, 7 vs 4 days) with a higher proportion of macula-off detachments (80 of 125 [64%] in 2020 vs 75 of 145 [51.7%] in 2018 and 78 of 151 [51.6%] in 2019). The 2020 cohort included significantly fewer patients in the racial and/or ethnic minority group than in 2019 (P = .02), and use of low-income, government-sponsored health insurance was a predictor of macula-off status during the pandemic (P = .04). RRDs during the spring 2020 COVID-19 lockdown were more likely to be macula-off at presentation. Because sociodemographic factors including race, ethnicity, and income level were associated with deferral of care, ophthalmologists should consider measures targeting vulnerable populations to avoid preventable vision loss as the pandemic continues or in future health care emergencies.

Visual Diagnosis: Abnormal Behavior in a 2-month-old Boy.

Visual Diagnosis: Abnormal Behavior in a 2-month-old Boy.

Effects of the COVID-19 pandemic on noise pollution in three protected areas in metropolitan Boston (USA)

Noise pollution can reduce the ability of urban protected areas to provide a refuge for people and habitat for wildlife. Amidst an unprecedented global pandemic, it is unknown if the changes in human activity have significantly impacted noise pollution in metropolitan parks. We tested the hypothesis that reduced human activity associated with the COVID-19 pandemic lockdowns would lead to reduced sound levels in protected areas compared with non-pandemic times. We measured sound levels in three urban protected areas in metropolitan Boston, MA (USA) at three time periods: in the fall and summer before the pandemic, immediately after the government-imposed lockdown in March 2020 when the trees were leafless, and during the beginning of reopening in early June 2020 when the trees had leaves. At all time periods, sound levels were highest near major roads and demonstrated a logarithmic decrease further from roads. At the two protected areas closest to the city center, sound levels averaged 1–3 dB lower during the time of the pandemic lockdown. In contrast, at the third protected area, which is transected by a major highway, sound levels were 4–6 dB higher during the time of the pandemic, likely because reduced traffic allowed vehicles to travel faster and create more noise. This study demonstrates that altered human levels of activity, in this case associated with the COVID-19 pandemic, can have major, and in some cases unexpected, effects on the levels of noise pollution in protected areas.

Fragmented governance, the urban data ecosystem and smart city-regions: the case of Metropolitan Boston

ABSTRACT Through an empirical focus on Metropolitan Boston, this paper examines the effects of territorial politics and fragmented metropolitan governance on an urban data ecosystem and endeavours to enact a smart city-region. The fragmented governance of Metro Boston reduces scales of economy and produces interjurisdictional data incompatibilities that limit spatial intelligence, foster back-to-back planning and stifle the benefits of open data. Highlighted is the irony that in order to address fragmented governance, there is a need for greater information-sharing, but that very activity is stymied because of a deeply rooted localist agenda that resists more collaborative, metro-regional governance arrangements.

Exposure to prior negative life events and responses to the Boston marathon bombings.

The objective of the study was to explore how type and timing of prior negative life experiences (NLEs) may be linked to responses to subsequent collective trauma, such as a terrorist attack. Using a longitudinal design, we examined relationships between prior NLEs and responses to the 2013 Boston Marathon bombings (BMB). Shortly after the BMB, a representative sample, compiled from metropolitan Boston (n = 846), New York (n = 941), and the rest of the United States (n = 2,888), reported BMB exposure and acute stress symptomatology. Six months later, we assessed prior NLEs, BMB-related posttraumatic stress symptoms, ongoing fear about future terrorism, and functioning. NLEs were classified by Diagnostic and Statistical Manual of Mental Disorders, fifth edition, criteria for traumatic events and other stressful experiences and by occurrence in childhood, adulthood (pre-BMB), and recent (past 6 months). Cumulative exposure to events, delineated by type and timing of occurrence, were contrasted; analyses adjusted for demographics, BMB-related exposure, and residential region. Post-BMB acute stress was associated with childhood (b = 0.88, 95% confidence interval [CI: 0.14, 1.61]) and adulthood (b = 0.83, 95% CI [0.21, 1.45]) trauma exposure. Exposure to childhood, adulthood, and recent traumatic events, as well as recent stressful events, was associated with higher BMB-related posttraumatic stress (ps < .05). Greater exposure to adulthood (b = 0.06, 95% CI [0.01, 0.11]) and recent (b = 0.30, 95% CI [0.01, 0.58]) trauma was associated with higher fear about future terrorism. Exposure to childhood (b = 0.17, 95% CI [0.07, 0.27]) and adulthood (b = 0.15, 95% CI [0.05, 0.25]) trauma and recent stressful events (b = 0.45, 95% CI [0.24, 0.66]) was associated with poorer functioning. Prior trauma may sensitize negative responses to collective trauma; recent stressors may exacerbate effects. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

The Metropolitan Waterworks Museum at Chestnut Hill pumping station, Boston, USA

The Metropolitan Waterworks Museum in Boston, Massachusetts, USA, occupies the engine room of the former Chestnut Hill high-service pumping station. This paper begins with an overview of the development of metropolitan Boston’s water system, which has always emphasised clean controlled sources and minimal processing. It describes the evolution of this architecturally significant building and its equally significant steam pumping engines over its 92-year operating life from 1888 to 1980. The subsequent approximately 30-year-long stakeholder process that led to the site’s preservation and the museum’s creation is reviewed, including the multilayered web of legislation, land-use agreements and particularly an underlying land disposition agreement, together with restrictions, easements, physical constraints, realpolitik considerations and the multiple operating-fund provisions that have made the museum’s successful creation and operation possible. Lastly, this paper cites some ongoing challenges.

Retrofitting business suburbia: competition, transformation, and challenges in metropolitan Boston’s suburban office parks

ABSTRACTThis paper examines the retrofitting and redevelopment of suburban office parks, and in particular, the planning, design, and policy issues and challenges associated with this redevelopment. Recent literature indicates a shift of suburban business development in favor of increasingly competitive central cities, a dilemma for planners charged with revitalizing aging suburban business parks. To understand the nature and causality of suburban office park retrofitting and redevelopment, we conducted 13 qualitative, semi-structured interviews with planners, developers, and officials in the inner Boston metropolitan region. Interviews indicated increasing obsolescence, with widespread redevelopment as a coping strategy. Strategies included densification, mixed uses, enhanced public spaces, and attempts to enhance transit. We examine two case studies: Northwest Park in Burlington, MA, and Needham Crossing, in Needham, MA: both are former office parks redeveloped as mixed-use developments. Our research clarifies the nature and types of physical redevelopment, as well as the specific motivations behind redevelopment as a planning strategy for enhancing the viability of aging suburban office developments.

SWS Distinguished Feminist Lecture: Feminist Politcal Economy in a Globalized World: African Women Migrants in South Africa and the United States

Based on research conducted over the past two decades, this lecture examines how the feminist political economy perspective can aid us in understanding the experiences of two populations of African women: Zimbabwean women cross-border traders in South Africa and African immigrant women in the northeastern United States. Feminist political economy compels us to explore the impact of the current phase of globalization as well as the roles of intersectionality and agency in the lives of African women. This research stems from fieldwork conducted in Harare and Bulawayo, Zimbabwe and Johannesburg and Cape Town, South Africa, as well as in metropolitan Boston and Philadelphia. Despite the many challenges that African migrant women face in these different venues, they continue to demonstrate much creativity and resilience and, in the process, they contribute to community development.

Community Use of Stationary and Mobile Pollution Monitors in Somerville and Metropolitan Boston MA USA

Over the last fifteen years, advocacy groups in Somerville and nearby communities have worked with environmental health research scientists and graduate students to study local air pollution and, more recently, noise patterns. These efforts can help inform community partners, policy leaders and regulatory agencies about serious environmental health risks. The results can help with land use and transportation decisions, and mitigation needs.Our community-based projects have ranged from short student practicums to formal multi-year research projects funded by NIH, EPA, HUD and Kresge Foundation. The practicums that we have engaged in have included consideration of turf vs natural athletic field exposures, lead in children&amp;#8217;s jewelry, community garden soil safety, bicyclist exposures and aviation noise patterns.In Somerville, a city of 80,000 with intense highway and diesel commuter rail exposures, we had the advantage of early near roadway pilot projects that used time integrated Nitrogen Oxide passive monitors and the Aerodyne Research mobile lab to show steep gradients of transportation related gases and ultrafine particle concentrations. This research, and public health records that showed a high correlation between surface transportation intensity and excess lung cancer and heart attack deaths, alerted us to the serious nature of transportation pollution. And to the need to bring local environmental health concerns to the forefront in policy and project decisions.Over the last decade we have also been engaged with Tufts and other universities in a series of near roadway research programs known as the Community Assessment of Freeway Exposure and Health (CAFEH). CAFEH has relied on intense mobile monitoring, assisted by stationary monitors, with a special focus on Ultrafine Particles, to relate biomarkers of cardiovascular risk in small populations to transportation sources. This research approach is difficult and might benefit from similar efforts at greater scale.

Community organizations and mental health after the 2013 Boston Marathon bombings

ObjectiveDisasters are place-based traumatic events, yet contemporary understandings of disaster recovery often do not consider the role of community organizations. We examine organization type and proximity as they relate to post-disaster mental health in a longitudinal study following the 2013 Boston Marathon bombings. MethodResidents of metropolitan Boston (N = 846) were recruited via a probability-based sampling strategy within weeks of the bombings and were surveyed several times over a two-year period. Residents of metropolitan New York (N = 941) were recruited and surveyed at the same time and used for comparison due to similarities in community demographics, geography, and disaster histories. We identified six different organization types nearby resident: safety-based organizations, religious organizations, educational organizations, child- and family-promoting organizations, health-based organizations, and voluntary community organizations. With possible environmental detriments (crowds and noise) or benefits of organizations amplified in areas closest to the resident, the concentration of these local organization types was examined at different distance-based boundaries. Contextual data for both communities came from the U.S. Census, Google Places API, and Guidestar. ResultsFor Boston metropolitan area residents, having more safety-based organizations within a half-mile to one-mile area in the aftermath of the bombings was associated with poorer functioning six to seven months later and greater psychological distress two years later. However, the presence of more safety-based organizations in the one to three mile area was associated with decreased psychological distress two years later. More health-based and voluntary community organizations in the half-mile to one-mile area were also associated with fewer fears and worries about future adversity two years post-bombing. Exposure to the bombings and other community traumas moderated this relationship among Boston area participants. ConclusionResults suggest that local community organizations are not merely buildings or structures but ecological sources of support to those in need after a disaster.

Community change and resident needs: Designing a Participatory Action Research study in Metropolitan Boston

The health implications of urban development, particularly in rapidly changing, low-income urban neighborhoods, are poorly understood. We describe the Healthy Neighborhoods Study (HNS), a Participatory Action Research study examining the relationship between neighborhood change and population health in nine Massachusetts neighborhoods. Baseline data from the HNS survey show that social factors, specifically income insecurity, food insecurity, social support, experiencing discrimination, expecting to move, connectedness to the neighborhood, and local housing construction that participants believed would improve their lives, identified by a network of 45 Resident Researchers exhibited robust associations with self-rated and mental health. Resident-derived insights into relationships between neighborhoods and health may provide a powerful mechanism for residents to drive change in their communities.

Psychosis screening practices in schools: A survey of school-based mental health providers.

Many school districts in the United States employ mental health professionals to provide assessment, counselling and crisis interventions within the school setting; however, little is known about actual clinical practices of psychosis screening in schools. The aim of the present study is to examine attitudes and practices regarding psychosis screening among school mental health providers in metropolitan Boston, Massachusetts. School-based mental health clinicians (N = 100) completed an anonymous survey assessing familiarity, screening, and involvement with psychosis and psychosis risk prior to attending trainings on psychosis. Providers reported screening for psychosis less often than other mental health problems and rated themselves as less confident treating psychosis relative to other mental health concerns. Frequency of screening for psychosis was significantly associated with familiarity with psychosis assessment and case management, confidence providing treatment for individuals experiencing psychosis, and the number of students with or at risk for psychosis with whom providers had been involved. Frequency of screening for psychosis was not associated with years of practice, suggesting that both novice and experienced school-based providers may benefit from training on this issue. Community outreach via school-based provider training on assessment and management of psychosis may help to increase providers' understanding of psychosis and increase the practice of verbal or written screening for psychosis and psychosis risk within schools.

Comparisons of traffic-related ultrafine particle number concentrations measured in two urban areas by central, residential, and mobile monitoring

Traffic-related ultrafine particles (UFP; <100 nm diameter) are ubiquitous in urban air. While studies have shown that UFP are toxic, epidemiological evidence of health effects, which is needed to inform risk assessment at the population scale, is limited due to challenges of accurately estimating UFP exposures. Epidemiologic studies often use empirical models to estimate UFP exposures; however, the monitoring strategies upon which the models are based have varied between studies. Our study compares particle number concentrations (PNC; a proxy for UFP) measured by three different monitoring approaches (central-site, short-term residential-site, and mobile on-road monitoring) in two study areas in metropolitan Boston (MA, USA). Our objectives were to quantify ambient PNC differences between the three monitoring platforms, compare the temporal patterns and the spatial heterogeneity of PNC between the monitoring platforms, and identify factors that affect correlations across the platforms. We collected >12,000 h of measurements at the central sites, 1000 h of measurements at each of 20 residential sites in the two study areas, and >120 h of mobile measurements over the course of ∼1 year in each study area. Our results show differences between the monitoring strategies: mean 1 min PNC on-roads were higher (64,000 and 32,000 particles/cm3 in Boston and Chelsea, respectively) compared to central-site measurements (23,000 and 19,000 particles/cm3) and both were higher than at residences (14,000 and 15,000 particles/cm3). Temporal correlations and spatial heterogeneity also differed between the platforms. Temporal correlations were generally highest between central and residential sites, and lowest between central-site and on-road measurements. We observed the greatest spatial heterogeneity across monitoring platforms during the morning rush hours (06:00-09:00) and the lowest during the overnight hours (18:00-06:00). Longer averaging times (days and hours vs. minutes) increased temporal correlations (Pearson correlations were 0.69 and 0.60 vs. 0.39 in Boston; 0.71 and 0.61 vs. 0.45 in Chelsea) and reduced spatial heterogeneity (coefficients of divergence were 0.24 and 0.29 vs. 0.33 in Boston; 0.20 and 0.27 vs. 0.31 in Chelsea). Our results suggest that combining stationary and mobile monitoring may lead to improved characterization of UFP in urban areas.

"Where It Falls Apart": Barriers to Retention in HIV Care in Latino Immigrants and Migrants.

Latino immigrants in the United States are disproportionately affected by HIV. Barriers to consistent attendance (retention) in HIV primary care constrain opportunities for HIV treatment success, but have not been specifically assessed in this population. We conducted semistructured interviews with 37 HIV-infected Latinos (aged ≥18 years and born in Puerto Rico or a Latin American Spanish-speaking country) and 14 HIV providers in metropolitan Boston (total n = 51). The Andersen Model of Healthcare Utilization informed a semistructured interview guide, which bilingual research staff used to explore barriers to HIV care. We used thematic analysis to explore the processes of retention in care. Six ubiquitous themes were perceived to influence HIV clinic attendance: (1) stigma as a barrier to HIV serostatus disclosure; (2) social support as a safety net during negative life circumstances; (3) unaddressed trauma and substance use leading to interruption in care; (4) a trusting relationship between patient and provider motivating HIV clinic attendance; (5) basic unmet needs competing with the perceived value of HIV care; and (6) religion providing a source of hope and optimism. Cultural subthemes were the centrality of family (familismo), masculinity (machismo), and trusting relationships (confianza). The timing of barriers was acute (e.g., eviction) and chronic (e.g., family conflict). These co-occurring and dynamic constellation of factors affected HIV primary care attendance over time. HIV-infected Latino immigrants and migrants experienced significant challenges that led to interruptions in HIV care. Anticipatory guidance to prepare for these setbacks may improve retention in HIV care in this population.

Media Use and Exposure to Graphic Content in the Week Following the Boston Marathon Bombings.

Traditional and new media inform and expose the public to potentially distressing graphic content following disasters, but predictors of media use have received limited attention. We examine media-use patterns after the Boston Marathon bombings (BMB) in a representative national U.S. sample (n=2888), with representative oversamples from metropolitan Boston (n=845) and New York City (n=941). Respondents completed an Internet-based survey 2-4weeks post-BMB. Use of traditional media was correlated with older age, prior indirect media-based exposure to collective traumas, and direct BMB exposure. New media use was correlated with younger age and prior direct exposure to collective traumas. Increased television and online news viewing were associated with exposure to more graphic content. The relationship between traditional and new media was stronger for young adults than all other age groups. We offer insights about the relationship between prior collective trauma exposures and media use following subsequent disasters and identify media sources likely to expose people to graphic content.

Establishment period of street trees growing in the Boston, MA metropolitan area

Slow growth following transplanting is characteristic of the establishment period, which has been studied for many years. Most of this work, however, has been conducted on trees transplanted in nurseries or favorable growing sites. In urban areas, many trees are transplanted into more challenging growing conditions, and very few studies have investigated establishment period of such trees. We analyzed ten years of transplanting records for the metropolitan Boston, MA, USA area to determine the establishment period of three species commonly planted as street trees {hedge maple [Acer campestre L.], London planetree [Platanus x acerifolia (Ait.) Willd.], and red oak [Quercus rubra L.]}. Using piecewise linear regression, we determined the “break point,” the intersection of two lines fitted to a scatter plot of caliper versus years after transplanting. The break point indicates the number of years after transplanting at which growth rate increases—the establishment period. We also analyzed whether site factors affected stem caliper. Establishment period varied among species: 2.1 years, 4.0 years, and 5.9 years for red oak, London planetree, and hedge maple, respectively. Site factors variably affected stem caliper of different species. Stem caliper of London planetree and red oak increased with greater sidewalk cut-out area. Tree grates in sidewalk cut-outs adversely affected stem caliper of London planetree. Our results can help practitioners manage street trees in the northeastern United States, but more work on trees transplanted in urban areas is necessary to understand the initial post-transplant growth of street trees.

Associations between Walk Score and Physical Activity in Overweight and Obese Women

PURPOSE: To examine the associations between the neighborhood Walk Score (WSc) and physical activity (PA) outcomes in a group of young, overweight/obese suburban and urban women. METHODS: Project Health included 48 overweight/obese black or white young women (BMI, 31.2 ± 3.7 kg/m2; age, 26.7 ± 4.6 years; 60% black) living in the metropolitan Boston area. An ActiGraph GT3X+ accelerometer (valid day and time defined as ≥ 8 hrs wear time on ≥ 3 days) was used to estimate mean steps/day and time (mins/day) in light PA (LPA; 100-2019 cpm) and moderate-to-vigorous PA (MVPA; ≥760 cpm). WSc measured the walkability of a participant’s home street address by analyzing walking routes to nearby amenities. Points were based on the distance to amenities; where amenities within a 5-min walk (0.25 miles) were given maximum points (range for WSc = 0-100 points). A decay function is used to assign fewer points to more distant amenities. Multiple linear regression was used to examine associations between WSc and physical activity outcomes (LPA, MVPA, and steps), adjusting for BMI, age, and race. RESULTS: Participants had a mean WSc of 62.9 ± 26.0, wore the accelerometers, on average, 831.3 ± 102.6 min/day for 7.0 ± 1.9 days, took 14,424 ± 4121 steps/day, spent 141.0 ± 43.4 mins/day in LPA and 118.6 ± 39.0 mins/day in MVPA. WSc was significantly and positively associated with steps/day (β=0.05 per 1000 steps, p<0.05), but was not associated with mins/day of LPA (p=0.16) or MVPA (p=0.33). Three subcategories of the WSc were significantly associated with steps/day; errands (β=0.06, p=0.009), shopping (β=0.05, p=0.03), and dining/drinking (β=0.05, p=0.02). Subcategory scores for schools, parks, grocery stores, and culture were not associated with steps/day. CONCLUSIONS: WSc was associated with daily steps but not mins/day in specific intensities (LPA or MVPA). Women with higher steps/day had higher amenity scores for shopping, errands and dining/drinking. Funding: This research was supported by a University of Massachusetts Boston Proposal Development Grant.

A framework for modeling contaminant impacts on reservoir water quality

Summary This study presents a framework for using hydrodynamic and water quality models to understand the fate and transport of potential contaminants in a reservoir and to develop appropriate emergency response and remedial actions. In the event of an emergency situation, prior detailed modeling efforts and scenario evaluations allow for an understanding of contaminant plume behavior, including maximum concentrations that could occur at the drinking water intake and contaminant travel time to the intake. A case study assessment of the Wachusett Reservoir, a major drinking water supply for metropolitan Boston, MA, provides an example of an application of the framework and how hydrodynamic and water quality models can be used to quantitatively and scientifically guide management in response to varieties of contaminant scenarios. The model CE-QUAL-W2 was used to investigate the water quality impacts of several hypothetical contaminant scenarios, including hypothetical fecal coliform input from a sewage overflow as well as an accidental railway spill of ammonium nitrate. Scenarios investigated the impacts of decay rates, season, and inter-reservoir transfers on contaminant arrival times and concentrations at the drinking water intake. The modeling study highlights the importance of a rapid operational response by managers to contain a contaminant spill in order to minimize the mass of contaminant that enters the water column, based on modeled reservoir hydrodynamics. The development and use of hydrodynamic and water quality models for surface drinking water sources subject to the potential for contaminant entry can provide valuable guidance for making decisions about emergency response and remediation actions.

Information Sharing Preferences of Older Patients and Their Families.

Elderly patients often share control of their personal health information and decision making with family and friends when needed. Patient portals can help with information sharing, but concerns about privacy and autonomy of elderly patients remain. Health systems that implement patient portals would benefit from guidance about how best to implement access to portals for caregivers of elderly patients. To identify how patients older than 75 years (hereinafter, elders) and family caregivers of such patients approach sharing of health information, with the hope of applying the results to collaborative patient portals. A qualitative study was conducted from October 20, 2013, to February 16, 2014, inviting participants older than 75 years (n = 30) and participants who assist a family member older than 75 years (n = 23) to 1 of 10 discussion groups. Participants were drawn from the Information Sharing Across Generations (InfoSAGE) Living Laboratory, an ongoing study of information needs of elders and families based within an academically affiliated network of senior housing in metropolitan Boston, Massachusetts. Groups were separated into elders and caregivers to allow for more detailed discussion. A professional moderator led groups using a discussion guide. Group discussions were audiotaped, transcribed, and analyzed inductively using immersion/crystallization methods for central themes. Central themes regarding sharing of health information between elderly patients and family caregivers. Seven lessons emerged from 2 main themes. First, sharing information has consequences: (1) elders and caregivers have different perspectives on what is seen as the "burden" of information, (2) access to medical information by families can have unintended consequences, and (3) elders do not want to feel "spied on" by family. Second, control of information sharing is dynamic: (4) elders wish to retain control of decision making as long as possible, (5) transfer of control occurs gradually depending on elders' health and functional status, (6) control of information sharing and decision making should be fluid to maximize elders' autonomy, and (7) no "one-size-fits-all" approach can satisfy individuals' different preferences. Information sharing and control are complex issues even under the most well-meaning circumstances. While elders may delegate control and share information with family, they want to retain granular control of their information. When using patient portals, simple proxy access may not adequately address the needs and concerns of aging patients.

Cumulative Exposure to Prior Collective Trauma and Acute Stress Responses to the Boston Marathon Bombings

The role of repeated exposure to collective trauma in explaining response to subsequent community-wide trauma is poorly understood. We examined the relationship between acute stress response to the 2013 Boston Marathon bombings and prior direct and indirect media-based exposure to three collective traumatic events: the September 11, 2001 (9/11) terrorist attacks, Superstorm Sandy, and the Sandy Hook Elementary School shooting. Representative samples of residents of metropolitan Boston (n = 846) and New York City (n = 941) completed Internet-based surveys shortly after the Boston Marathon bombings. Cumulative direct exposure and indirect exposure to prior community trauma and acute stress symptoms were assessed. Acute stress levels did not differ between Boston and New York metropolitan residents. Cumulative direct and indirect, live-media-based exposure to 9/11, Superstorm Sandy, and the Sandy Hook shooting were positively associated with acute stress responses in the covariate-adjusted model. People who experience multiple community-based traumas may be sensitized to the negative impact of subsequent events, especially in communities previously exposed to similar disasters.