Ashton Shortridge’s research while affiliated with Michigan State University and other places

Background Eleven years have passed since the 2014 Flint water crisis (FWC), yet many voices still go unheard. There is limited evidence of the impact of the FWC on maternal health. This paper used a cross-sectional study design to survey 152 women enrolled in the Supporting Parents and Raising Resilient Kids (SPARRK) study in Flint, Michigan to examine racial differences in women’s perceptions of their overall health pre- and post-FWC, perceived maternal health services, and explore the interaction of race and living in Flint on maternal morbidity. Methods Perceived maternal health was defined using the Centers for Disease Control and Prevention’s 21 Severe Maternal Morbidity (SMM) diagnosis codes. SMM were obtained via questionnaire. Logistic regression analyses were performed to identify factors associated with SMM within two domains: (1) overall health pre- and post-FWC and (2) perceived maternal health care received during birth. Results There were 17 cases of SMM in which Black women accounted for 62.5% of these cases. Perceived quality of care was overall positive; yet, perceived overall health decreased post-FWC for all women. The odds of SMM were 6 times higher for those who had a college degree or higher. Conclusion In the predominately Black city of Flint, race was not a significant factor in the perception of health and quality of care. Surprisingly, educational attainment was significantly associated with a 6-time increase in odds of experiencing an SMM. More research is needed to examine the association of patient-provider perception of quality care and education on maternal health outcomes.

Background Schoolyards and/or playgrounds are important settings for fostering children's social, cognitive, and physical development. Optimal schoolyard design is likely an important health‐promoting and equigenic strategy, but prior research does not fully consider multiple dimensions of these spaces, such as vegetation, slopes, ground cover, and equipment. Aims We describe the Schoolyard Level Inventory for Describing the Environment (SLIDE) a novel method to compile spatial data from multiple sources, including in‐person audits (e.g., cleanliness), images (e.g., greenness), and geographic information systems (e.g., distance to road), that can be linked with children's device data. Materials & Methods We illustrate use of SLIDE in 91 first and second graders from three elementary schools who wore an accelerometer and global positioning system (GPS) device during school recess. Multilevel linear regression was used to test associations between 22 environmental features and children's physical activity intensity and time spent (duration of play). Results The auditing process took two researchers ~30 min per 1000 m2 of schoolyard. Some features were consistent across schools (flatness, grass areas, views of the school), while other features varied (views of the road, covered areas, seated areas, slides, and colorful equipment). We found significant, independent, negative associations between physical activity intensity with redness and cleanliness, and positive associations with colorful equipment and distance to road. We detected significant, negative associations between time spent with greenness and fields, and a positive association with equipment condition. Discussion While many of our findings align with prior research, we note that SLIDE also provides new insights including a better understanding of the complex inter‐relationships between schoolyard features and outcomes. On a larger sample of more diverse schoolyards, this would allow researchers to identify which specific features should be the focus of future schoolyard designs or renovations. Conclusion SLIDE can be used to inform schoolyard design, assess greening or redesign interventions, and examine schoolyard inequalities, while accounting for complex inter‐relationships between features.

Vector-borne parasitic diseases (VBPDs) such as human African trypanosomiasis (HAT) pose a daily challenge to the ability to survive and thrive for inhabitants of remote rural sub-Saharan Africa. Social and ecological factors of the region compound the risks encountered by everyday subsistence living. Recent rhodesiense HAT (r-HAT) outbreaks in Malawi reinforce the need to think more broadly about approaches to control. The Simulated Models for Areas at Risk for Trypanosomiasis (SMART) leverage the social and ecological factors that increase area-wide exposure risk and produce a 1-km spatial resolution per-pixel map identifying areas where interactions among humans, animal reservoirs such as cattle, and tsetse fly, the insect vector of the disease, are greatest. Precision mapping approaches such as SMART could be useful in control and intervention priority setting. Stakeholder engagement in communities is another critical component in developing sustainable solutions to the control of tsetse and trypanosomiasis.

Objective Reducing children’s exposure to unhealthy food marketing is crucial to combat childhood obesity. We aimed to estimate the reduction of children’s exposure to food marketing under different policy scenarios and assess exposure differences by socioeconomic status. Design Data on children’s exposure to unhealthy food marketing was compiled from a previous cross-sectional study in which children (n=168) wore wearable cameras and GPS units for four consecutive days. For each exposure, we identified the setting, the marketing medium and food/beverage product category. We analyzed the percentage reduction in food marketing exposure for ten policy scenarios and by socioeconomic deprivation: 1) no product packaging, 2) no merchandise marketing, 3) no sugary drink marketing, 4) no confectionary marketing in schools, 5) no sugary drink marketing in schools, 6) no marketing in public spaces, 7) no marketing within 400m of schools, 8) no marketing within 400m of recreation venues, 9) no marketing within 400m of bus stops, and 10) no marketing within 400m of major roads. Setting Wellington region of New Zealand. Participants 168 children aged 11-14 years. Results Exposure to food marketing varied by setting, marketing medium and product category. Among the 10 policy scenarios, the largest reductions were for plain packaging (60.3%), no sugary drink marketing (28.8%) and no marketing in public spaces (22.2%). There were no differences by socioeconomic deprivation. Conclusions The results suggest that plain packaging would result in the greatest decrease in children’s exposure to food marketing. However, given that children are regularly exposed to unhealthy food marketing in multiple settings through a range of marketing mediums, comprehensive bans are needed to protect children’s health.

This paper investigated the surface length of roads from both horizontal and vertical perspectives using the theory of fractal dimension of surfaces and curves. Three progressive experiments were conducted. The first demonstrated the magnitude of the differences between the planar road length and the DTM-derived surface road length and assessed its correlation with the DTM-calculated road slope. The second investigated the road distance complexity through the fractal dimension in both planar and vertical dimensions. The third related the vertical with the horizontal fractal dimension of roads across a range of distinct physiographic regions. The study contributed theoretically by linking the planimetric complexity to vertical complexity, with clear applications for advanced transportation studies and network analyses. The core methodology used geographic information systems (GIS) to integrate a high resolution (1 × 1 m) digital terrain model (DTM) with a road network layer. A novel concept, the vertical fractal dimension of roads was introduced. Both the vertical and horizontal fractal dimensions of the roads were calculated using the box-counting methodology. We conducted an investigation into the relationship between the two fractal dimensions using fourteen study areas within four distinct physiographic regions across Slovenia. We found that the average slope of a three-dimensional (3D) road was directly related to the length difference between 3D and two-dimensional (2D) roads. The calculated values for the vertical fractal dimension in the study areas were only slightly above 1, while the maximum horizontal fractal dimension of 1.1837 reflected the more sinuous properties of the road in plan. Variations in the vertical and horizontal fractal dimensions of the roads varied between the different physiographic regions.

Background Racial injustices, both within the social and environmental aspect, are increasingly in national discussions due to impacts from the COVID-19 pandemic and persistent violence perpetrated by police against Black civilians that resulted in tragic deaths. An ongoing environmental injustice that began in 2014 is the Flint Water Crisis (FWC). The purpose of this study is to conduct a quasi-experimental research design to compare Flint to a sociodemographically similar city to determine what effect, if any, the FWC had on maternal health from 2012 to 2017 across three time periods: pre-during-and-post-FWC. Methods The Centers for Disease Control and Prevention (CDC)'s 21 severe maternal morbidity (SMM) rates severed as indicators of maternal health status and were collected from the Michigan Inpatient Database. Differences between non-Hispanic Black and non-Hispanic White race codes determined the maternal health disparity gap. R-statistical software and k-mean analysis were used to analyze cities that were comparable to Flint. Difference-in-difference methodology was used to compare the difference in SMM rates for Flint and a sociodemographically comparable city. Results On average, non-Hispanic Black women had a higher odds of experiencing a SMM across all three time periods: pre-FWC = 1.29, during-FWC = 1.2, and post-FWC = 1.05. Conclusions Maternal health outcomes observed in Flint during the FWC are significantly influenced by race. The study showed that regardless of a woman giving birth in a predominantly Black city, an environmental hazard, and her age range, maternal health disparities are still present if that woman identifies as Black.

Children's exposure to the marketing of harmful products in public outdoor spaces may influence their consumption of those products and affect health into adulthood. This study aimed to: i) examine the spatial distribution of children's exposure to three types of marketing-related ‘harms’ (alcohol, unhealthy food, and gambling) in outdoor spaces in the Wellington region, New Zealand/Aotearoa; ii) compare differences in the distribution of harms by socioeconomic deprivation; and iii) estimate the effectiveness of different policies that ban such marketing. Data were from 122 children aged 11–13y who wore wearable cameras and GPS devices for four consecutive days from July 2014 to June 2015. Images were analysed to identify harmful product marketing exposures in public outdoor spaces. Eight policy scenarios were examined to identify the effectiveness of marketing bans, for all children and by socioeconomic deprivation. Children's ratio of harmful marketing was higher for children from high deprivation households and was also found to cluster, with hots spots observed around city centers. The effectiveness of marketing bans depended on the target setting and ban area, with banning 400 m around bus stops leading to the largest reduction. Effectiveness varied also by type of harm and socioeconomic deprivation. For example, banning alcohol marketing in residential areas was estimated to have a larger effect on exposure reduction for children from high deprivation households. Our findings suggest that alcohol, unhealthy food and gambling marketing often cluster outdoors and that targeted bans of such marketing would likely improve child health and, for some banning scenarios, promote equity.

Domestic racial and ethnic minorities have been persistently underrepresented in U.S. geography doctoral programs. Efforts to improve diversity have taken many forms over the years, but most have been short-lived with limited success. In this article, we introduce the Advancing Geography Through Diversity Program (AGTDP), a four-pronged cohort-based model that systematically and sustainably increases the presence of African Americans, Hispanic Americans, and Native Americans in geography doctoral programs. The program is currently in its fourth year in the Department of Geography, Environment, and Spatial Sciences at Michigan State University. Context for the development of the framework is provided, followed by a detailed discussion of each pillar of the program: recruitment, support, engagement, and retention. We evaluate the current state of the program along with lessons learned for successful implementation. To date, the program has effectively increased the representation across all three underrepresented groups within the department’s doctoral program. We believe the AGTDP can serve as a model for more widespread deployment to other geography departments.