12 research outputs found
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Exempted: Spatial Clustering of Intentionally Unvaccinated Children in California and its Potential Consequences for Measles Transmission
No full textRates of non-medical vaccine exemptions have been increasing in the U.S. since the early 1990s. These exemptions tend to be spatially clustered rather than randomly occurring in the population. In contrast to long-standing public health findings, under-vaccination due to non-medical exemptions tends to be found among children with educated, affluent, non-Hispanic white parents rather than those with relatively disadvantaged backgrounds. This dissertation uses data on Personal Beliefs Exemptions (PBEs) in schools in California from 1998-2014 and an empirically-calibrated large-scale simulation experiment to understand how spatial clusters of these exemptions form and their potential consequences for measles transmission. This dissertation emphasizes the importance of interaction in social networks in structuring both the local context surrounding parents’ vaccine decisions and the patterns of physical contact through which disease spreads. Major findings show that residential sorting of parents into neighborhoods and schools based on socio-demographic characteristics associated with school-level PBE rates provides only a partial explanation for broader patterns of clustering. Additional analyses provide evidence of spillover effects between PBE rates and socio-demographic characteristics, particularly percent non-Hispanic white children, on PBE rates in nearby schools.A large-scale simulation of measles transmission using a synthetic population of youth in California in 2014 is then used to examine the potential consequences of PBEs for disease spread. Schools serve as hotspots for measles transmission regardless of the spatial locations of PBEs, although clustering of these exemptions within households and charter schools increase the opportunities for infections. Surprisingly, spatial pockets of PBEs may provide slight protection against measles transmission when outbreak sizes are small and the disease is introduced randomly into the population. Yet, clustering of exemptions can reduce protective effects of herd immunity to large measles epidemics, even when overall vaccination coverage in the population is high.This dissertation concludes by drawing connections between findings in the empirical chapters and linking the results to the larger theoretical context of social interaction in networks. Practical implications for vaccine policy and efforts to control vaccine-preventable disease are discussed. Overall, this project seeks to illustrate how decisions perceived as personal by parents contribute to collective health outcomes
From “tippecanoe and tyler, too” to “born in the U.S.A.”: The transformation of the campaign song in presidential elections in the united states
No full textThe Roles of Neighborhood Composition and Autism Prevalence on Vaccination Exemption Pockets: A Population-wide Study
No full textAbstractThe number of children entering schools without mandated vaccinations has increased in high-income countries due to the rise of nonmedical exemptions from school vaccination requirements. Herd immunity is threatened when unvaccinated children are concentrated in spatial pockets. It is often assumed that these exemption clusters are merely the result of population composition. On the other hand, despite the role of vaccine-autism controversy to the current wave of anti-vaccine movement, we do not know if exemption clusters are associated with local autism rates. Our spatial analysis of California shows that while racial/ethnic composition is associated with the locations of large exemption pockets, other sociodemographic factors and access to health care resources have limited geographical span. We decouple the race/ethnicity effect from that of unobserved socioeconomic status by examining families in poverty. Using unique address-level data on the locations of the majority of children with an autism diagnosis, we show that the prevalence of autism is not associated with the locations of large pockets of vaccination exemptions. In addition, we find charter schools in most exemption clusters; potential spillovers from charter schools to neighboring public schools are evaluated. Exemption pockets are not merely the result of population composition and community-level interventions are needed to maintain herd immunity.HighlightsAutism prevalence rates are not associated with the locations of large exemption pockets.The average exemption rate in charter schools (7.5%) was higher than private schools.Proportion non-Hispanic white has the strongest association with large exemption clusters.Population composition cannot fully explain the exemption clusters.</jats:sec
Recent Trends in Public Protest in the United States: The Social Movement Society Thesis Revisited
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In utero exposure to threat of evictions and preterm birth: Evidence from the United States
No full textOBJECTIVE: To estimate county-level associations between in utero exposure to threatened evictions and preterm birth in the United States. DATA SOURCES: Complete birth records were obtained from the National Center for Health Statistics (2009-2016). Threatened evictions were measured at the county level using eviction case filing data obtained from The Eviction Lab (2008-2016). Additional economic and demographic data were obtained from the United States Census Bureau and Bureau of Labor Statistics. STUDY DESIGN: We conducted a retrospective cohort analysis using 7.3 million births from 1,633 counties. We defined threatened eviction exposures as the z-score of average case filings over the pregnancy and by trimester. Our primary outcome was an indicator for preterm birth (born < 37 completed weeks of gestation). Secondary outcomes included a continuous measure for gestational length, a continuous measure for birth weight, and an indicator for low birth weight (born < 2500 g). We estimated within-county associations controlling for individual- and time-varying county-level characteristics, state-of-residence-year-and-month-of-conception fixed effects, and a county-specific time trend. DATA COLLECTION/EXTRACTION: We merged birth records with threatened eviction data at the county-month-year level using mother's county of residence at delivery and month-year of conception. We supplemented these data with information on county-level annual 18-and-over population, annual poverty rate, and monthly unemployment rate. PRINCIPAL FINDINGS: Increased levels of eviction case filings over a pregnancy were associated with an increased risk of prematurity and low birth weight. These associations appeared to be sensitive to exposure in the second and third trimesters. Associations with secondary outcomes and within various population subgroups were, in general, imprecisely estimated. CONCLUSIONS: Higher exposure to eviction case filings within counties, particularly in the latter stages of a pregnancy, was associated with an increased risk of adverse birth outcomes. Future research should identify the causal effect of threatened evictions on maternal and child health outcomes
Spatial Concentration and Spillover: Eviction Dynamics in Neighborhoods of Los Angeles, California, 2005–2015
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Spatial Concentration and Spillover: Eviction Dynamics in Neighborhoods of Los Angeles, California, 2005–2015
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The Neighborhood Context of Eviction in Southern California
No full textIn the United States, soaring rent burdens and a dearth of affordable housing leave millions of renters at risk of eviction. The eviction epidemic is particularly pronounced in California where advocates estimate that approximately 500,000 renters are evicted annually. Research has looked at individual–level determinants of evictions, but we know much less about the spatial dynamics of eviction and associations across neighborhoods. This is largely because data on evictions are sporadic and incomplete. We utilize data from American Information Research Services, Inc., that consists of publicly available California eviction court records for Los Angeles, Orange, Riverside, San Bernardino, and San Diego Counties between 2005 and 2015. We append eviction locations to two waves of the American Community Survey (ACS) to better understand the connection between concentrated disadvantage and neighborhood change and eviction. We find that evictions are much more likely to occur in neighborhoods with higher poverty rates and/or shares of African–American individuals than in neighborhoods with rising rent or income levels. These findings suggest that court–based evictions are much more likely to be found in areas with low–income households and racial minorities than in areas experiencing rapid neighborhood change as evidenced by rising rents or changing demographics
