An Analysis of Costs and Health Co-Benefits for a U.S. Power Plant Carbon Standard

Reducing carbon dioxide (CO₂) emissions from power plants can have important “co-benefits” for public health by reducing emissions of air pollutants. Here, we examine the costs and health co-benefits, in monetary terms, for a policy that resembles the U.S. Environmental Protection Agency’s Clean Power Plan. We then examine the spatial distribution of the co-benefits and costs, and the implications of a range of cost assumptions in the implementation year of 2020. Nationwide, the total health co-benefits were $29 billion 2010 USD (95% CI: $2.3 to $68 billion), and net co-benefits under our central cost case were $12 billion (95% CI: -$15 billion to $51 billion). Net co-benefits for this case in the implementation year were positive in 10 of the 14 regions studied. The results for our central case suggest that all but one region should experience positive net benefits within 5 years after implementation.     

Association between Smoking and Latent Tuberculosis in the U.S. Population: An Analysis of the National Health and Nutrition Examination Survey

Background

Evidence of an association between cigarette smoking and latent tuberculosis infection (LTBI) is based on studies in special populations and/or from high prevalence settings. We sought to evaluate the association between LTBI and smoking in a low prevalence TB setting using population-based data from the National Health and Nutrition Examination Survey (NHANES).

Methods

In 1999–2000, NHANES assessed LTBI (defined as a tuberculin skin test measurement ≥10 mm) in participants, and those ≥20 years of age were queried regarding their tobacco use and serum cotinine was measured. We evaluated the association of LTBI with self-reported smoking history and smoking intensity in multivariable logistic regression models that adjusted for known confounders (gender, age, birthplace, race/ethnicity, poverty, education, history of BCG vaccination, and history of household exposure to tuberculosis disease).

Results

Estimated LTBI prevalence was 5.3% among those ≥20 years of age. The LTBI prevalence among never smokers, current smokers, and former smokers was 4.1%, 6.6%, and 6.2%, respectively. In a multivariable model, current smoking was associated with LTBI (OR 1.8; 95% CI, 1.1–2.9). The association between smoking and LTBI was strongest for Mexican-American and black individuals. In multivariate analysis stratified by race/ethnicity, cigarette packs per day among Mexican-American smokers and cotinine levels among black smokers, were significantly associated with LTBI.

Conclusions

In the large, representative, population-based NHANES sample, smoking was independently associated with significantly increased risks of LTBI. In certain populations, a greater risk of LTBI corresponded with increased smoking exposure.     

Social Transformation and Its Human Costs in the Prehispanic U.S. Southwest

ABSTRACT  Change is inevitable, but some changes and transformations are more dramatic and fraught with suffering than others. Resilience theory suggests the concept of a rigidity trap as an explanation for these differences. In rigidity traps, a high degree of connectivity and the suppression of innovation prolong an increasingly rigid state, with the result that the eventual transformation is harsh. Three archaeological cases from the U.S. Southwest (Mimbres, Mesa Verde, and Hohokam) and new methods for assessing transformations and rigidity are used to evaluate this concept. They reveal the expected association between the severity of transformation and degree of rigidity, suggesting that a rigidity trap contributed to the Hohokam decline, which included significant human suffering. Possible causes of rigidity, with implications for today's world, are explored.     

美国可再生燃料标准实施机制与市场跟踪

可再生燃料标准(RFS)是美国政府为提高生物燃料利用量,减少石油对外依存度与温室气体排放而制定的强制执行指令.美国环保署(EPA)根据RFS目标确定可再生燃料在道路交通燃料中的混配比例,并强制要求美国汽柴油炼制、混配与进口等责任商完成当年可再生燃料配比责任量(RVO);责任商需在年末向EPA提交足够多的可再生燃料身份码(RINs)以示完成任务.RINs跟随可再生燃料的生产或进口而获取,是跟踪可再生燃料利用与监测RFS目标是否完成的主要依据.独立的RINs可自由交易并形成市场,责任商可选择购买RINs来完成年度RVO.文中介绍了美国RFS的管理机制、实施进展与影响评价,重点介绍了RINs的产生、跟踪与交易.     

More Than Class: Studying Power in U.S. Workplaces

More Than Class: Studying Power in U.S. Workplaces. Ann E. Kingsolver. ed. New York: State University of New York Press, 1998. 222 pp.     

An Evaluation of Rebuilding Policies for U.S. Fisheries

Rebuilding depleted fish populations is a priority of modern fisheries management. In the U.S., strong statutory mandates extend to both the goals and process by which stocks are to be rebuilt. However, the National Standard Guidelines that govern the implementation of the Magnuson-Stevens Fishery Conservation and Management Act may change to increase flexibility in rebuilding requirements. In this study we evaluate performance of the status quo approach to fish stock rebuilding in the United States against 3 alternatives that have been proposed to improve rebuilding outcomes. These alternatives either simplify the analytical requirements of rebuilding analyses or apply ‘best practices’ in fisheries management, thereby avoiding the need for rebuilding analyses altogether. We use a Management Strategy Evaluation framework to evaluate rebuilding options across 6 fish life history types and 5 possible real-world fishery scenarios that include options for stock assessment quality, multiple fleets, and the degree to which the stocks are overfished at the start of the analysis. We show that the status quo rebuilding plan and a harvest control rule that reduces harvest rates at low stock size generally achieve the best rebuilding outcomes across all life-history types and fishery scenarios. Both approaches constrain fishing in the short term, but achieve high catches in the medium and long term as stocks rebuild to productive levels. These results support a growing body of literature that indicates that efforts to end overfishing early pay off in the medium- to long-term with higher cumulative catches than the alternative.     

Examining Associations between Health Information Seeking Behavior and Adult Education Status in the U.S.: An Analysis of the 2012 PIAAC Data

This paper presents data from the Program for the International Assessment of Adult Competencies with a focus on the interrelationships among health information seeking behavior (HISB), and health status or use of preventive health measures for U.S. adults both with and without a high school diploma. Key results of ordinal and binary logistic regression analyses indicated that, after controlling for demographic factors, (1) adults with a high school diploma use more text-based health information sources while adults without a high school diploma use more oral sources, (2) using the Internet as a source of health information is more strongly related to reporting excellent/very good health status than having a high school diploma, (3) those without a high school diploma who use the Internet report the largest increase in health status over any other health information source, and (4) for those with learning disability or vision problem, a high facility in reading English is an important predictor of whether the Internet is used as a health information source. The Internet appears to play a key role in both enhancing health status and enabling use of preventive measures for those with and without a high school diploma; although, individuals without a high school diploma who use the Internet for health information derive substantial benefit in health status.     

美国SECURE规则评析及其对中国的启示

美国农业部动植物卫生检疫局在最近一次生物技术法规的修订中,将原有的关于监管利用基因工程开发的生物体的进口、州际移动和环境释放一章的规定进行了较大幅度的修改,并将之命名为SECURE规则。这一规则采用了新的安全评价方法,将评价的重心从原来的生产方法转移到了产品的特性上。此外,新的规则还通过豁免程序和监管状态审查等程序的设立,进一步简化了监管方式。但SECURE规则也存在着部门立法之间的协调不足、配套机制建设不完善等问题,可能给新规则的实施带来一定的挑战。我国作为转基因技术大国,在农业生物技术及其产品监管的立法上可以批判性地借鉴美国最新的立法实践,为我国生物技术产业的发展提供法治保障。     

美国电子健康档案发展策略及启示

美国是电子健康档案建设的先行者,经过40余年的发展,取得了显著进展,并在电子健康档案的组织建设、标准制定、资金筹集、隐私与安全保护、利益相关者协调方面积累了丰富的经验。主要论述了美国电子健康档案的发展历程及具体策略,以期为我国电子健康档案建设提供借鉴。     

Reasons for Relinquishment of Companion Animals in U.S. Animal Shelters: Selected Health and Personal Issues

In personal interviews, people surrendering their dogs and cats to 12animal shelters in 4 regions of the country discussed their reasons for relinquishing their companion animals and answered questions about their own characteristics and those of their pet. The interviews identified 71 reasons for relinquishment. Personal issues lead the class of reasons for relinquishment of cats and ranked 3rd among those given for relinquishment of dogs. The top 3 health and personal issues cited for giving up cats were allergies of a family member to cats, owner's personal problems, and anew baby. For dogs, the top 3 reasons cited were lack of time for the dog, owner's personal problems, and allergies. Analysis of these health and personal issues suggests that education and counseling before and after acquisition of a pet, as well as the availability of temporary accommodations for pets during times of personal crisis, may reduce relinquishments.     

Combining Surveillance Systems: Effective Merging of U.S. Veteran and Military Health Data

Background

The U.S. Department of Veterans Affairs (VA) and Department of Defense (DoD) had more than 18 million healthcare beneficiaries in 2011. Both Departments conduct individual surveillance for disease events and health threats.

Methods

We performed joint and separate analyses of VA and DoD outpatient visit data from October 2006 through September 2010 to demonstrate geographic and demographic coverage, timeliness of influenza epidemic awareness, and impact on spatial cluster detection achieved from a joint VA and DoD biosurveillance platform.

Results

Although VA coverage is greater, DoD visit volume is comparable or greater. Detection of outbreaks was better in DoD data for 58% and 75% of geographic areas surveyed for seasonal and pandemic influenza, respectively, and better in VA data for 34% and 15%. The VA system tended to alert earlier with a typical H3N2 seasonal influenza affecting older patients, and the DoD performed better during the H1N1 pandemic which affected younger patients more than normal influenza seasons. Retrospective analysis of known outbreaks demonstrated clustering evidence found in separate DoD and VA runs, which persisted with combined data sets.

Conclusion

The analyses demonstrate two complementary surveillance systems with evident benefits for the national health picture. Relative timeliness of reporting could be improved in 92% of geographic areas with access to both systems, and more information provided in areas where only one type of facility exists. Combining DoD and VA data enhances geographic cluster detection capability without loss of sensitivity to events isolated in either population and has a manageable effect on customary alert rates.     

Health Insurance Status as a Barrier to Ideal Cardiovascular Health for U.S. Adults: Data from the National Health and Nutrition Examination Survey (NHANES)

Background

Little is known about the association between cardiovascular (CV) health and health insurance status. We hypothesized that U.S. adults without health insurance coverage would have a lower likelihood of ideal cardiovascular health.

Methods and Results

Using National Health and Nutrition Examination Survey (NHANES) data from 2007–2010, we examined the relationship between health insurance status and ideal CV health in U.S. adults aged ≥19 years and <65 (N = 3304). Ideal CV health was defined by the American Heart Association (AHA) as the absence of clinically manifested CV disease and the simultaneous presence of 6–7 “ideal” CV health factors and behaviors. Logistic regression modeling was used to determine the relationship between health insurance status and the odds of ideal CV health. Of the U.S. adult population, 5.4% attained ideal CV health, and 23.5% were without health insurance coverage. Those without health insurance coverage were more likely to be young (p<0.0001), male (p<0.0001), non-white (p<0.0001), with less than a high school degree (p<0.0001), have a poverty-to-income ratio less than 1 (p<0.0001) and unemployed (p<0.0001) compared to those with coverage. Lack of health insurance coverage was associated with a lower likelihood of ideal CV health; however, this relationship was attenuated by socioeconomic status.

Conclusions

U.S. adults without health insurance coverage are less likely to have ideal CV health. Population-based strategies and interventions directed at the community-level may be one way to improve overall CV health and reach this at-risk group.     

Preparation and Standardization of U.S. Standard Pertussis Vaccine, Lot No. 11

The Center for Biologics Evaluation and Research within the U.S. Food and Drug Administration has prepared a new U.S. Standard Pertussis Vaccine. Whole cell pertussis vaccine concentrate was diluted in 5% (w/v) lactose and lyophilized. The preparation was tested for toxicity, sterility heterogeneity and residual moisture. Based on data from an international sollaborative study involving 11 laboratories, the potency was estimated in relation to the U.S. Master Standard Pertussis Vaccine, Lot 4 and the International Standard for Pertussis Vaccine, Lot 2. The potency of the preparation was defined to be 90 units per ampoule. When reconstituted and stored according to instructions, no significant change in potency was observed in the 14 days following reconstitution. This material was shown to be suitable for a pertussis vaccine standard and accordingly it was designated as U.S. Standard Pertussis Vaccine, Lot 11 on March 22, 1994.     

Examining the Links between Biodiversity and Human Health: An Interdisciplinary Research Initiative at the U.S. Environmental Protection Agency

Under the U.S. Environmental Protection Agency’s mission to protect human health and the environment, the agency seeks to conduct research on the structure and function of ecosystems and to improve our understanding of the processes that contribute to the sustained health of the nation’s ecosystems and the well-being of human populations. Changes in biodiversity can profoundly impact the ability of ecosystems to provide clean water, energy, food, recreation, and other services that contribute to human well-being. In addition, changes in biodiversity can affect the transmission of infectious disease to humans, particularly vectorborne diseases such as malaria and Lyme disease. The Environmental Protection Agency’s new initiative supports interdisciplinary research to characterize the mechanisms that link biodiversity and human health and to use this knowledge to develop integrative tools and approaches for quantifying and predicting these relationships. Research on these links can have an important impact on our view of biodiversity and how we manage resources to protect human and ecosystem health. Disclaimer: This work was funded in part under Grant #CX3-832328 with the American Association for the Advance of Science (AAAS). The views expressed do not necessarily reflect the views of the Environmental Protection Agency.