Rest Of County Research Articles

Modeling spatial spillover effect on intersection crash propensity: a case study at the county level in Ohio

The characteristics of intersection crashes are not only affected by the subject intersection where the crash occurs but also are correlated with environmental conditions of neighboring analysis zones. There are few studies on intersection crash analysis to solve certain spatial effects on microscopic safety issues by proactively incorporating highway safety improvement measures into the long-term transportation planning process. The objective of this paper is to develop a heuristic traffic safety analysis system where spatial spillovers analysis is integrated into roadway safety assessment to incorporate micro variables and macro variables. With K-means clustering technique in a GIS environment, 8 hotspot counties are identified from 88 counties in Ohio, which have high intersection crash propensity. The rest of counties are identified as general counties. Then, an innovative integrated Generalized Linear Model is adopted to identify 11 and 20 significant variables that contribute to the intersection crash propensity in hotspot counties and general counties, respectively. To verify compatibility of intersection crash frequency models with macro-level and micro-level measurement, Reading Road in Cincinnati, Hamilton County (hotspot county) and I-71 in Mason City and Lebanon City of Warren County (general county) are used as examples for the test, and the results show a good consistence.

Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012

IntroductionEmergency Departments experience a significant census burst after disasters. The aim of this study is to describe patient presentations at Emergency Departments in Contra Costa County, California following chemical release incidents at an oil refinery in 2007 and 2012. Specific areas of focus include hospital and community burden with an emphasis on disease classes.MethodsSearching 4 weeks before through 4 weeks after each event, Emergency Department abstracts identified patients living in Contra Costa County and seeking care there or in neighboring Alameda County. City and ZIP-code of residence established proximity to the refinery. This provided the following contrast groups: Event (2007, 2012), time (before, after), location (bayside, rest of county), and within bayside, warned or not warned to shelter in place. Using the Multi-Level Clinical Classification Software, we classified primary health groups recorded 4 weeks before and after the events, then summarized the data, calculated rates, and made tables, graphs, and maps to highlight findings.ResultsNumber of visits meeting selection criteria totalled 105020 records. Visits increased modestly but statistically significantly after the 2007 incident. After the 2012 incident, two Emergency Departments took the brunt of the surge. Censuses increased from less than 600 a week each to respectively 5719 and 3072 the first week, with the greatest number 2 days post-event. It took 4 weeks for censuses to return to normal. The most common diagnosis groups that spiked were nervous/sensory, respiratory, circulatory, and injury. Bayside communities had statistically significant increases in residents seeking care. Specifically, visits of residents in warned communities nearest the refinery increased by a factor of 3.7 while visits of residents in other nearby un-warned communities increased by a factor of 1.5.ConclusionsThe 2012 Emergency Department census peaked in the first week and did not return to normal for 4 weeks. Diagnoses changed to reflect conditions associated with reactions to chemical exposures. Surrounding communities and nearby hospitals experienced significant emergent burdens. In addition to changes from such events in patient diagnoses and community burden, the discussion highlights the long-term implications of failures to require adequate monitoring and warning systems and failures of health planning.

Reproductive outcomes after non-occupational exposure to hexavalent chromium, Willits California, 1983-2014

BackgroundFrom 1963–1995, a factory in Willits, Mendocino County, CA used toxic hexavalent chromium (Cr(VI)) without adequate measures to protect the population. We use longitudinal hospital data to compare reproductive outcomes for two generations in Willits and two generations in the Rest of County (ROC). This is the first study to quantify the reproductive impact of Cr(VI) in a non-occupational population.MethodsWe searched California hospital discharge data (1983–2014) to find Mendocino County residents born 1950 or later. ZIP-code 95490 identifies Willits residents, with all others living in ROC. We used the Multi-Level Clinical Classification Software (CCS) to classify health outcomes.First, we calculated the crude birth rate using an external census denominator. The next two models used self-contained denominators to assess health of infants and two generations of pregnant women. Finally, we focused on non-pregnant females and, for comparison, males. Here we added admissions for people who moved, linked and summarized admissions to the person level, and calculated rates per census population.ResultsWe found 29311 newborn records in ROC and 5036 from Willits. At start of period, Willits birth rate was low and did not recover until 12 years after Plant closure. While the Plant was open, respiratory conditions, perinatal jaundice, and birth defect rates were higher for Willits infants compared to ROC, but improved post-closure. Risk for abnormal birthweight and term was high and remained high over the study period.During the period under study, we identified 31444 admissions of pregnant ROC women and 5558 from Willits. Willits women had significantly higher risk of pregnancy loss compared to ROC, whether stratified by generation, age group, or pre- and post-closure. Regardless of when exposed, Willits women continued to have significantly higher rates of in-hospital terminations, as animal studies of Cr(VI) exposure predict. In life course models, non-pregnant Willits women have significantly higher risk of reproductive organ conditions and neoplasms compared to ROC.ConclusionsAdverse reproductive outcomes are elevated and consistent with animal studies. General health outcomes reflect the same broad effect reported for occupationally exposed workers. For the first time, the detrimental reproductive effects of non-occupational Cr(VI) exposure in human females and their infants is reported.

Interest Groups, County Characteristics, and Local Growth Management Policy Instruments

The primary intent of this study is to investigate what factors drive local governments to implement growth management policy instruments. To answer this research question, this study chose Colorado counties, where local governments voluntarily adopt and implement growth management policy instruments. That means that a wide variation in growth management policy instrument implementation appears among Colorado???s local governments. That is to say, some counties more actively implement growth management policy instruments while the rest of counties do not. Utilizing a statistical tool, this article tests seven hypotheses based on the interest group model and county characteristics to empirically explicate this uneven implementation phenomenon of growth management policy instruments across Colorado. The analyzed results prove that counties with many anti-growth management policy interest groups are less likely to implement growth management policy instruments. In addition, the analyzed results demonstrate both that counties earning more income from tourism and counties with highly educated residents are more likely to implement growth management policy instruments, while counties supporting the Democratic Party are less likely to implement growth management policy instruments.

Longitudinal analysis of health outcomes after exposure to toxics, Willits California, 1991-2012: application of the cohort-period (cross-sequential) design.

BackgroundAbout 1963, a factory in Willits, Mendocino County (County), California added chrome plating to the manufacture of steel products. After years of residents reporting high illness rates, the State undertook a series of investigations. They found exposures had been high and warranted further research into possible health effects. Applying the seldom-used cross-sequential design, we tested if Willits had an excess rate of adverse health conditions, compared to people of the same sex and cohort living in the rest of county (ROC). This is the first report on long-term health outcomes for Willits.MethodsHospital discharge data for 1991–2012 were searched to find admissions for people born between 1940 and 1989 who ever gave the County as their residence. Diagnoses and procedures were classified to Level 1 (body systems) of the Multi-level Clinical Classification Software (CCS). We analyzed 796,917 diagnoses and 289,980 procedures found on 117,799 admissions of 43,234 patients who lived in the County at some time between 1991 and 2012. Of these, 7,564 lived in Willits. We summarized data to the person-level then the group level over cohort-period (cross-sequential) to control the age by time relationship, then calculated incidence rates, relative risk, and excess case statistics, each with confidence limits. A secondary analysis focused on whether Willits differed markedly from the rest of County (ROC). Specifically, other than the presence of the Plant, did Willits differ so much that those differences could plausibly explain outcome differences?ResultsIllness was excessive in the exposed group (Willits) compared to the unexposed (ROC). Overall number of excess cases attributable to living in Willits was estimated: Men, 301 (95% confidence limit (CL) 200–398), women: 696 (CL 569–820).ConclusionsThis study demonstrates the strength of the cross-sequential design. Willits and ROC had comparable disadvantages relative to the State. Yet, when stratified by cohort, Willits had more illness per population. Little is known about the health effect of chemicals used at Willits on a non-occupationally exposed population. We recommend a follow-up study to evaluate the long-term health of people who lived in Willits during childhood and the reproductive age.Electronic supplementary materialThe online version of this article (doi:10.1186/1476-069X-13-88) contains supplementary material, which is available to authorized users.

A radiographic survey of periapical conditions in elderly people in a Swedish county population.

Abstract A random sample of non‐institutionalized people aged 65 years and over in Örebro County, Sweden, were examined radiographically. Periapical conditions and the prevalence and quality of root fillings were evaluated. Approximately every 10th tooth showed radiographic signs of apical periodontitis: more than 1 in 20 teeth not previously root‐filled and more than 1 in 4 root‐filled teeth. Only 28% of the subjects had no tooth with periapical destruction. In all, 18% of the teeth were root‐filled: 27% of maxillary teeth and 11% of mandibular teeth. Periapical destructions were less prevalent in people with many remaining teeth and among married people as compared to the rest of the population. Periapical destructions were more common in subjects from “rest of county” as compared to “densely‐populated areas”. Variations in treatment quality might be one explanation for this difference. The percentage of root fillings classified as “unacceptable” was high (69%).