Washtenaw County Research Articles

Student Interest Drives Modernization of Climate Science Curriculum: Engaging with Community Partners Outside the Classroom

Abstract As climate change continues to accelerate, there is a growing need for collaboration between geoscientists and community partners to co-create equitable science-based climate solutions that align with community priorities. However, the curriculum of many geoscience Ph.D. programs focus almost exclusively on physical science knowledge production confined to the academic sphere with little attention to usability or applications of climate information to decision-making. A consequence is that there is often little educational support to train future generations of geoscientists with the skills needed to serve as knowledge brokers and interpret climate information into the context needed for decision-making. To address this, a group of students and faculty at the University of Michigan developed a pilot course to provide hands-on experience engaging with local communities to develop climate solutions. This project involved a collaboration with the Washtenaw County Water Resources Commissioner's Office to discuss their high-priority objectives. The inaugural project involved identifying high-priority locations in Washtenaw County for rain garden development to be used for internal planning purposes. The process of recurring communications with partners played a critical role in tailoring the project to have ongoing use for local government after the course. This project provided a student driven bridge between climate knowledge production, climate science usability and community engagement. This type of formal engagement with community partners provides opportunities to train the next generation of geoscientists to have the skills to engage with practitioners and decision-makers and make climate science more accessible.

505 Use of Expanded Access at Michigan Medicine and Associations with Neighborhood Factors

OBJECTIVES/GOALS: Socioeconomic status (SES) affects risk of disease and access to therapies. The expanded access (EA) pathway allows for the clinical use of investigational products for patients who have serious illness but no Food and Drug Administration (FDA)-approved therapeutic options. The SES of patients who receive EA is unknown. METHODS/STUDY POPULATION: We reviewed the patients who were approved for treatment through a single-patient EA pathway between 2018 and 2023. Using Michigan Medicine (MM) DataDirect software linked to the MM electronic medical record system, we linked the EA pathway patients to neighborhood data from the National Neighborhood Data Archive (NaNDA) to compare neighborhood related markers of affluence among EA patients and others treated at MM. We used descriptive statistics to compare variables between EA pathway patients and residents of the state of Michigan or the local county surrounding MM (Washtenaw County), using US Census tract data to provide context for these findings. RESULTS/ANTICIPATED RESULTS: MM patients who received EA treatments were more likely to come from neighborhoods that showed markers of high SES compared to residents of the state of Michigan but not Washtenaw County. This includes the proportion of persons living in poverty (12.5% EA / 13.4% Michigan / 12.4% Washtenaw) and education in the form of a bachelor’s degree or higher (32.2% / 30.6% / 57.2%). This varied by the disease being treated. Oncology patients were more likely to be from areas with less poverty and more education (12.4% / 76.8%) than the EA average. EA patients being treated for infectious diseases were from areas with more poverty and less education (13.5% / 26.7%). DISCUSSION/SIGNIFICANCE: Patients treated at Michigan Medicine using treatments obtained through the EA pathway came from areas that were, on average, more affluent than residents of the state of Michigan as a whole. This finding warrants more research to ensure equitable access to these therapies for patients in disadvantaged neighborhoods.

230 Assessing the Role of Youth Sports in Diabetes Prevention and Perceived Discrimination

OBJECTIVES/GOALS: Our study aims to 1) examine the link between engagement in CLR Academy and youth diabetes risk factors—physical activity, nutrition, mental health, and weight status; 2) examine CLR’s role in moderating the relationship between perceived discrimination and these risk factors. Includes a program evaluation of CLR & interviews of members. METHODS/STUDY POPULATION: Youth-onset diabetes is rising in American minority communities. Youth sports programs like the Community Leadership Revolution (CLR) Academy in Washtenaw County, MI are emerging responses to this issue. CLR targets diabetes risk factors through team sports by promoting mindfulness and healthy habits. Employing a mixed-methods, pretest-posttest approach, our study focuses on how the frequency of engagement in CLR impacts CLR’s effect on youth’s diabetes risk factors. Considering the discrimination minority youth experience, we also aim to see if CLR potentially buffers the impact of perceived discrimination on diabetes risk factors. A posttest program evaluation of CLR will also include semi-structured interviews with CLR staff and participants. RESULTS/ANTICIPATED RESULTS: There is potential that youth with high engagement in CLR Academy may see enhanced benefits in managing diabetes risk factors compared to less active participants. This may be particularly true for youth experiencing high perceived discrimination, with potential marked improvements in mental health, like reduced anxiety and depression. Additionally, through a program evaluation and semi-structured interviews, our study aims to uncover the factors contributing to CLR’s success as a community-led intervention while also identifying areas for enhancement. Post-study, CLR will receive financial support to integrate these insights into their program, furthering their effectiveness in youth diabetes prevention and overall well-being. DISCUSSION/SIGNIFICANCE: This study may provide significant insights into the relationship between sports participation, diabetes risk factors, and perceived discrimination. The findings could help CLR improve its program and guide more effective diabetes prevention strategies in minority youth through other youth sports programs.

Use of Contraception Among Hispanic Women and Men: A Qualitative Study.

Nationally, low-income women of Hispanic ethnicity have a significantly higher rate of unintended pregnancy than their White counterparts. This disparity leads to an increased risk for poor maternal and child outcomes that have long and short-term sequelae for health and well-being. A quantitative report in Washtenaw County, Michigan in 2017 found that both men and women were at high risk for unintended pregnancy with many women reporting no contraception use, despite not desiring a pregnancy. We used semistructured interviews to assess the opinions and experiences regarding the use of contraception among 21 Hispanic women and men of reproductive age in a Midwestern county. Our study found that the use of contraception to prevent unwanted pregnancy was important to our sample of Hispanic women and men. However, concerns about side effects, limited knowledge on reproductive health, the influence of partners, and financial barriers played a role in the use of contraception. Our findings provide insight into the influences and barriers to contraception use among Hispanic women and men and can inform future research.

Prosecutor Transparency Project: Racial Disparities Study (Washtenaw County, Michigan)

Prosecutor Transparency Project: Racial Disparities Study (Washtenaw County, Michigan)

University of Michigan First to Test APA Model for Assessing Psychiatric Bed Needs

University of Michigan First to Test APA Model for Assessing Psychiatric Bed Needs

Assessing Safety Performance on Urban and Suburban Roadways of Lower Functional Classification: An Evaluation of Minor Arterial and Collector Roadway Segments

Previous research of urban roadway safety performance has generally focused on roadways of high functional classifications, such as principal arterials. However, roadways with lower functional classifications, including minor arterials and collectors, typically possess characteristics that differ from those of higher roadway classes. Therefore, assumptions made on the general effect of the predictor variables from typical safety performance functions may not apply to lower roadway classes. To address these knowledge gaps, a safety performance evaluation of urban/suburban minor arterial and collector roadway segments was performed using traffic and roadway data along with 8 years of crash data from 189 mi of two-lane urban and suburban roadways in Washtenaw County, MI. Mixed-effects negative binomial models with a segment-specific random intercept were developed for minor arterial and collector road segments, considering total-, fatal and injury-, and property damage only crashes. In general, minor arterial roadways showed greater crash occurrence compared with collector roads. Posted speed limit had a significant positive association with crash frequency, and this effect increased when the speed limit exceeded 40 mph. The effect of speed limit was stronger on minor arterial segments and for fatal and injury crashes. Additionally, driveway density was found to have a significant effect on safety performance, which was stronger for commercial/industrial driveways compared with residential driveways and for collector roads compared with minor arterials, particularly when considering residential driveways. On-street parking was associated with lower crash occurrence, with a stronger effect on collector roadways, most likely because of greater parking turnover when compared with minor arterials.

Effects of Social Determinants of Health on Infant Mortality in Washtenaw and Wayne County, Michigan

Effects of Social Determinants of Health on Infant Mortality in Washtenaw and Wayne County, Michigan

Why Did a "Howling Wilderness" Become Michigan's Capital?

Why Did a "Howling Wilderness" Become Michigan's Capital? Eric Dobberteen (bio) In 1847, Michigan traded its capital for a swamp.1 Detroit had been Michigan's territorial and state capital since 1805 and had become the state's biggest city and a significant port. By the 1830s, it was also an entrepot for settler migration from the East Coast to the Great Lakes and the old Northwest Territory. So why move the capital at all? And why move it to a "howling wilderness" that only in time would become the city of Lansing?2 Considering the capital-placement experiences of the twenty-five states that preceded Michigan into the United States, moving the capital from Detroit was nearly inevitable. By the time Michigan became a state in 1837, many other states had moved their original capitals, some several times. These moves usually resulted from intra-state sectional pressures created as populations spread (usually westward) from the first settlements. Lower Michigan's three neighbors—Ohio, Indiana, and Illinois—had all moved capitals from their originally settled geographic edges to sites closer to the center of each state. There was little chance that Detroit, regardless of its size, wealth, and power, could remain Michigan's capital perched in the southeastern corner of a large and growing state. In contrast, the legislature's surprising 1847 selection of Lansing—little more than a sawmill on the Grand River—was not inevitable, and the reasons behind it were more complicated.3 It is important to examine Michigan's experience not just in terms of how pressure grew to move the capital from Detroit, but also why it was moved to Lansing. The state developed its own brand of sectionalism between and among the four east-to-west tiers of counties stretching across the southern half of the Lower Peninsula; a sectionalism that ultimately influenced the 1847 legislative process, allowing legislators from the two northern tiers to join forces and snatch the capital from more likely candidates. [End Page 107] Thanks in part to the opening of the Erie Canal in 1825, Detroit in the early 1830s was growing and vibrant, but its role as the capital came under attack as early as 1835, before Michigan officially became a state. In June 1835, delegates drafting what would become the state's first constitution debated the issue of moving the capital. Votes to move it, at least temporarily, to Ann Arbor in Washtenaw County or Barry in Jackson County ultimately failed, as did counter attempts to make Detroit the permanent capital.4 Though the delegates made no final decision during the convention, they specified in Section 9 of Article XII of the first constitution that Detroit continue as the capital until 1847 pending selection of a "permanent" site.5 By 1847, every state but Massachusetts had moved its capital at least once. While each state's circumstances varied, this history had common themes Michigan repeated.6 Moving a capital frequently resulted from the natural outward migration of a state's population from the originally settled area containing the capital to the more remote frontier. This demographic expansion created sectional tensions and political pressures to move the capital closer to a shifted population center. Christian Montès referred to this repeated process as a "westward/centrality" pattern that occurred in twenty-two different states.7 Michigan's nearest neighbors in the Northwest Territory—Ohio, Indiana, and Illinois—had experienced this centralizing process, moving their capitals from their first-settled edges toward their geographical centers.8 The westward/centrality pull on a capital was more than a desire for some abstract geographical symmetry. The outwardly dispersing population generally created a rural/urban divergence of occupation, class, wealth, and even religion between the older and newer regions. These differences engendered intra-state sectionalism frequently summarized as a rural distrust of cities, often including the original capital. One historian concluded that the westward movement of capitals was "almost exclusively a [intra-state] sectional issue."9 Michigan experienced this same pattern. As its population moved westward and northward from the southeast corner of the state, the same rural/urban divisions took hold. Many Michiganders soon concluded that Detroit wielded too much...

Evaluation of 1,4-dioxane attenuation processes at the Gelman Site, Michigan, USA

1,4-Dioxane released at the Gelman Site in Washtenaw County, Michigan, produced a series of contaminant plumes migrating up to 3 km through a heterogenous glacial aquifer system. An analysis of 1,4-dioxane concentrations in the Eastern Area of the Gelman Site between 2011 and 2017 documented a mass balance deficit of 2200 kg in excess of 2100 kg of 1,4-dioxane removed via remediation. Five mechanisms were evaluated to account for the mass deficiency: sorption, matrix diffusion, biodegradation, surface discharge, and bypass of the existing monitoring well network.The mass of 1,4-dioxane sorbed to aquifer and aquitard materials and the mass of 1,4-dioxane diffused into low permeability zones were estimated. However, decreasing aqueous concentrations across most of the contaminated area between 2011 and 2017 are expected to induce desorption and back diffusion during this period. Surface water discharge to a storm drain in the downgradient portion of the site was analyzed using concentration measurements and stream gage data. Results suggest that 1,4-dioxane mass entering the drain during the period between 2011 and 2017 was insufficient to account for the mass deficiency.Although available geochemical measurements indicate predominantly anaerobic aquifer conditions at the Gelman Site, biodegradation of 1,4-dioxane was estimated using first order decay rate constants from other sites where conditions may be more favorable. Results suggest that biodegradation could explain some but not all of the missing mass.Bypass of the downgradient monitoring well network is the most parsimonious explanation for the 1,4-dioxane mass deficit. This conclusion is supported by documented flow path complexity through the aquifer system and the sparse density of monitoring wells in the downgradient Eastern Area. These findings underscore the importance of characterizing aquifer heterogeneity when modeling and remediating persistent groundwater contaminants such as 1,4-dioxane.

Is Justice by Zoom Justice Denied?: Judicial Stakeholder and Legal Advocate Experiences of Video-Mediated Trial Courts in Washtenaw County

Is Justice by Zoom Justice Denied?: Judicial Stakeholder and Legal Advocate Experiences of Video-Mediated Trial Courts in Washtenaw County

377. SARS-CoV-2 Genomic Surveillance Reveals Little Spread Between a Large University Campus and the Surrounding Community

BackgroundUnderstanding SARS-CoV-2 transmission dynamics is critical for controlling and preventing outbreaks. The genomic epidemiology of SARS-CoV-2 on college campuses has not been comprehensively studied, and the extent to which campus-associated outbreaks lead to transmission in nearby communities is unclear. We used high-density genomic surveillance to track SARS-CoV-2 transmission across the University of Michigan-Ann Arbor campus and Washtenaw County during the Fall 2020 semester.MethodsWe retrieved all available residual diagnostic specimens from the Michigan Medicine Clinical Microbiology Laboratory and University Health Service that were positive for SARS-CoV-2 from August 16th – November 25th, 2020 (n = 2245). We extracted viral RNA, amplified the SARS-CoV-2 genome by multiplex RT-PCR, and sequenced these amplicons on an Illumina MiSeq. We applied maximum likelihood phylogenetic analysis to whole genome sequences to define and characterize transmission lineages.ResultsWe assembled complete viral genomes from 1659 individual infections, representing roughly 25% of confirmed cases in Washtenaw County across the fall semester. Of these cases, 468 were University of Michigan students. Phylogenetic analysis revealed 203 genetically distinct introductions of SARS-CoV-2 into the student population, most of which were singletons (n = 171) or small clusters of 2 – 8 students. We identified two large SARS-CoV-2 transmission lineages (115 and 73 students, respectively), including individuals from multiple on-campus residences. Viral descendants of these student outbreaks were rare, constituting less than 4% of cases in the community.ConclusionWe identified many SARS-CoV-2 transmission introductions into the University of Michigan campus in Fall 2020. While there was widespread transmission among students, there is little evidence that these outbreaks significantly contributed to the rise in COVID-19 cases that Washtenaw County experienced in November 2020.Disclosures Adam Lauring, MD, PhD, Roche (Advisor or Review Panel member) Sanofi (Consultant)

SARS-CoV-2 Genomic Surveillance Reveals Little Spread From a Large University Campus to the Surrounding Community.

BackgroundCoronavirus disease 2019 (COVID-19) has had high incidence rates at institutions of higher education (IHE) in the United States, but the transmission dynamics in these settings are poorly understood. It remains unclear to what extent IHE-associated outbreaks have contributed to transmission in nearby communities.MethodsWe implemented high-density prospective genomic surveillance to investigate these dynamics at the University of Michigan and the surrounding community during the Fall 2020 semester (August 16–November 24). We sequenced complete severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from 1659 individuals, including 468 students, representing 20% of cases in students and 25% of total cases in Washtenaw County over the study interval.ResultsPhylogenetic analysis identified >200 introductions into the student population, most of which were not related to other student cases. There were 2 prolonged student transmission clusters, of 115 and 73 individuals, that spanned multiple on-campus residences. Remarkably, <5% of nonstudent genomes were descended from student clusters, and viral descendants of student cases were rare during a subsequent wave of infections in the community.ConclusionsThe largest outbreaks among students at the University of Michigan did not significantly contribute to the rise in community cases in Fall 2020. These results provide valuable insights into SARS-CoV-2 transmission dynamics at the regional level.

Learning From Youth: Using Positive Outcomes to Evaluate Summer Youth Employment Programs

Summer Youth Employment Programs (SYEPs) help connect youth to opportunities for career exploration, skill development, and mentorship. Despite heightened investment in SYEPs, research regarding positive impacts is limited. Most of the common SYEP evaluation strategies are rooted in deficit thinking and focus on outcomes such as reducing violent crime, risk behaviors, gaps in unemployment, and increasing educational attainment. Despite recent shifts toward approaches that acknowledge structural oppression in adolescent research more broadly, evaluations of SYEPs often perpetuate a discourse of deficiency about marginalized communities by emphasizing disparities without acknowledging the systemic forces that create them. In this article, we utilize the Five Cs of Positive Youth Development to present an alternative set of outcomes identified from focus groups and surveys with youth ages 16 to 24 who participated in SummerWorks, a 10-week SYEP located in Washtenaw County, Michigan. Specifically, we find that SYEPs may help youth make the transition to adulthood, build community and increase their social capital, and access knowledge, resources, and opportunities. Through this approach, we hope to expand the literature on the impacts of SYEPs and encourage antiracist evaluation strategies that build on these findings and challenge deficit thinking.

Did Clostridioides difficile Testing and Infection Rates Change During the COVID-19 Pandemic?

Background: The COVID-19 pandemic has underscored the importance of ongoing infection prevention efforts. Increased adherence to infection prevention recommendations, increased antibiotic use, improved hand hygiene, and correct donning and doffing of personal protective equipment may have influenced healthcare-associated infections (HAIs) in the United States during the pandemic. In this study, we investigated testing for Clostridioides difficile infection (CDI) and incidence during the initial surge of the pandemic. We hypothesized that strict adherence to contact precautions may have resulted in a decreased incidence of CDI in hospitalized patients during the first peak of the COVID-19 pandemic and that CDI testing may have increased even in the absence of directed diagnostic stewardship efforts. Methods: We conducted a single-center, retrospective, observational study at the Veterans’ Affairs (VA) Hospital in Ann Arbor, Michigan, between January 2019 and June 2020. We compared data on CDI tests from January 2019 through February 2020 to data from March 2020 (the admission of the first patient with COVID-19 at our institution) through June 2020. Pre-peak and peak periods were defined by confirmed cases in Washtenaw County. No novel diagnostic or CDI-focused stewardship interventions were introduced by the antimicrobial stewardship program during the study period. An interrupted time series analysis was performed using STATA version 16.1 software (StataCorp LLC, College Station, TX). Results: There were 6,525 admissions and 34,533 bed days between January 1, 2019, and June 30, 2020. Also, 900 enzyme immunoassay (EIA) tests were obtained and 104 positive cases of CDI were detected between January 2019 and June 2020. A statistically significant decrease in EIA tests occurred after March 1, 2020 (the COVID-19 peak in our region) compared to January 1, 2019–March 1, 2020 (Figure 1). After March 1, 2020, the number of EIA tests obtained decreased by 10.2 each month (95% CI, −18.7 to −1.7; P = .02). No statistically significant change in the incidence of CDI occurred. The use of antibiotics that were defined as high risk for CDI increased in the months of April–June 2020 (Figure 2). Conclusions: In this single-center study, we observed a stable incidence of CDI but decreased testing during the first peak of the COVID-19 pandemic. Understanding local HAI reporting is critical because changes in HAI reporting structures and exemptions during this period may have affected national reporting. Further research should be undertaken to investigate the effect of COVID-19 on other HAI reporting within the US healthcare system.Funding: NoDisclosures: None

The Statewide Economic Impact of Child Care-Associated Viral Acute Gastroenteritis Infections.

More than 65% of children aged ≤5 years in the United States require out-of-home child care. Child care attendance has been associated with an elevated risk of respiratory illness and acute gastroenteritis (AGE). While child care-associated respiratory disease cases are more numerous, AGE is associated with more severe symptoms and more than double the number of absences from child care. In addition, viral pathogens such as norovirus, rotavirus, and adenovirus are highly infectious and may be spread to parents and other household members. As a result, child care-associated viral AGE may incur substantial economic costs due to healthcare service usage and lost productivity. We used surveillance data from a network of child care centers in Washtenaw County, Michigan, as well as a household transmission model to estimate the annual cost of child care-associated viral AGE in the state of Michigan. We estimated that child care-associated viral AGE in Michigan costs between $15 million and $31 million annually, primarily due to lost productivity. The economic burden of child care-associated infections is considerable. Effective targeted interventions are needed to mitigate this impact.

Assessing Community Needs to Combat the Opioid Epidemic in Washtenaw County, Michigan

A needs assessment was performed to inform the strategic plan of the Washtenaw Health Initiative Opioid Project (WHI-OP). A Health Resources & Services Administration-funded preventive medicine resident supported this work by conducting and analyzing surveys and face-to-face interviews. Surveys were distributed to community organizations involved in opioid prevention and treatment and medical providers in the major health care systems. Individual interviews were conducted with key stakeholders. Overall, the top 5 needs identified were (1) pain management treatment options, (2) addressing provider stigma, (3) community education of opioids and substance abuse, (4) access to substance use disorder treatment, and (5) better guidelines to manage care for patients with substance use disorder, given the evolving Michigan prescription laws. The findings served as a foundation for a new strategic plan for the WHI-OP. The needs assessment was accomplished through the work of the preventive medicine resident in close collaboration with the WHI-OP and the Washtenaw County Health Department.

Characterization of noise exposure in places of worship

BackgroundThe addition of concert instrumentation to contemporary religious services has exposed attendees to increased noise levels, which may contribute to noise-induced hearing loss (NIHL). Many smart device noise level measurement applications (apps) have been developed to assist in evaluation of noise exposure. However, there have been no published studies on noise exposure in American places of worship. ObjectiveWe evaluated noise exposure in several different types of places of worship in Washtenaw County, Michigan, United States as well as the accuracy of smart device noise level measurement apps. MethodsNoise levels were measured at 26 services in 20 different places of worship using a combination of Spark 706RC dosimeters and iPod Touches running the US National Institute for Occupational Safety and Health (NIOSH) Sound Level Meter app. Dosimeters were programmed to measure according to the exposure limits recommended by the Environmental Protection Agency (EPA) for community noise and NIOSH for occupational noise. Relevant details on \\ the services that could impact audience exposure to noise were recorded. ResultsThe mean equivalent continuous average exposure (LEQ) level was significantly higher in audience measurements of Non-denominational places of worship in comparison to all other places (p = 0.004). Audience and podium LEQ levels were significantly higher if there were three or more vocal ensemble members (p = 0.001). No significant differences were noted between dosimeter and iPod LEQ levels. Roughly 35% of EPA measurements in the audience, 39% of EPA measurements at the podium, and 8% of NIOSH measurements at the podium exceeded the recommended exposure limits. ConclusionsA significant portion of measured services exceeded recommended noise exposure limits. The current results may support the need for additional noise exposure screening and potential noise reduction interventions in places of worship.

Suicide attempt and intentional self-harm during the earlier phase of the COVID-19 pandemic in Washtenaw County, Michigan

ObjectiveDetermine the early impact of the COVID-19 pandemic on emergency department (ED) encounters for suicide attempt and intentional self-harm at a regional tertiary academic medical centre in Washtenaw County, Michigan,...

First person profile: Lori J. Pierce, MD: First African American, first female radiation oncologist to serve as American Society of Clinical Oncology president makes equity her theme.

First person profile: Lori J. Pierce, MD: First African American, first female radiation oncologist to serve as American Society of Clinical Oncology president makes equity her theme.