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23 Dec, 15 tweets, 9 min read
1. For your holiday reading pleasure, a special section was just published @AMJPublicHealth on "New Frontiers in Environmental Justice". I was privileged to co-edit it with @DrDianaHernandz. This is a very important topic at a very important time. So what's in the issue? 🧵
2. First, @DrDianaHernandz and I provide a roadmap for the articles, emphasizing how much has changed since a similar special section a decade earlier. This includes escalating burden of climate change, structural racism, and political extremism.

ajph.aphapublications.org/doi/10.2105/AJ…
3. An article by Goldsmith and @MichelleScience describes pathways that contribute to disproportionate environmental burdens on the LGTBQ+ population, a population often ignored in environmental justice work.

ajph.aphapublications.org/doi/10.2105/AJ…
4. Two commentaries on this article reinforce the importance of an intersectional lens in the pursuit of environmental justice.

ajph.aphapublications.org/doi/10.2105/AJ…

ajph.aphapublications.org/doi/10.2105/AJ…
5. Another article by McDonald @amizota and colleagues on the environmental injustice of beauty products addresses intersectionality and reinforces disproportionate burdens on multiple minoritized populations.

ajph.aphapublications.org/doi/10.2105/AJ…
6. Some legacy environmental justice issues require novel approaches or methods to address them. For example, Pace @cushing_lara @rmfrosch and colleagues used geospatial data to characterize racial/ethnic disparities in drinking water quality in CA.

ajph.aphapublications.org/doi/10.2105/AJ…
7. Climate change is also a key element of modern environmental justice, and Ryti et al. examined the effects of cold weather on cardiac arrest while Schwarz @TBenmarhnia et al. looked at the effects of heat waves on the homeless.
ajph.aphapublications.org/doi/10.2105/AJ…

ajph.aphapublications.org/doi/10.2105/AJ…
8. Multiple authors grappled with the importance of overburdened communities having a seat at the table to address environmental injustice. @DCarrionEnviro @annie_belcourt and @DrCHFuller emphasized the importance of community-engaged research.

ajph.aphapublications.org/doi/10.2105/AJ…
9. @dbourland and colleagues emphasized how funding processes need to prioritized frontline organizations working in overburdened communities, and Atencio et al. discussed the importance of meaningful Tribal consultation.

ajph.aphapublications.org/doi/10.2105/AJ…

ajph.aphapublications.org/doi/10.2105/AJ…
10. In addition, Sullivan et al. discuss the importance of children's environmental health at US EPA with an EJ emphasis, and @DrDianaHernandz discusses the importance of housing as a key element of resilient communities.

ajph.aphapublications.org/doi/10.2105/AJ…

ajph.aphapublications.org/doi/10.2105/AJ…
11. We need to train the next generation of public health students to address these important issues. @crlevy13 (no relation) et al. argue that CEPH criteria for MPH education need to change to address the erosion of environmental health content.

ajph.aphapublications.org/doi/10.2105/AJ…
12. One commentary by 9 EH department chairs across the US reinforces how we need to recenter EH in public health education. since EH knowledge is central to many of the public health challenges we currently face.

ajph.aphapublications.org/doi/10.2105/AJ…
13. A second commentary on education by Guidotti and Cwikel emphasizes the need to reorient public health education to address "wicked problems" and help create sustainable communities.

ajph.aphapublications.org/doi/10.2105/AJ…
14. Anyway, that's a lot of content to drop just before the holidays. And there will be more articles on these themes @AMJPublicHealth in the months ahead. Racial justice, health inequities, climate change, and other issues discussed are the central challenges of our time.
15. (Apologies if I did not tag any authors on these articles - it was a good-faith effort)

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More from @jonlevyBU

Jon Levy Profile picture
26 Dec
1. In the coming weeks, you will be in a room with someone with #COVID19. But that doesn’t mean you will get infected. The dose makes the poison, so your goal is to reduce your dose as much as possible.

How do you do that? TL;DR - #BetterMasks, ventilation, and filtration 🧵
2. First the basics - Watanabe et al. 2010 published a dose-response model for SARS-CoV, which has been used as the conceptual foundation for SARS-CoV-2 risk modeling. You want to get yourself as far to the left as possible. Image
3. The question is, how much dose reduction is possible using simpler measures under your control?

Important to remember that measures are cumulative and multiplicative. So stack a few up and you can make a big difference.
Read 11 tweets
Jon Levy Profile picture
7 Dec
Look at the #COVID19 wastewater signal for Greater Boston, which tells us where cases are heading next week. It has NEVER been this high, even at last winter's peak. And vax rates in MA are generally higher in Greater Boston. And this is likely before #Omicron. Action now #mapoli Image
We have a choice:
1) Indoor mask mandate, all-out effort for boosters and vaccinations in vulnerable communities, expansion of testing
2) Do nothing, and watch as health care system is overloaded and families are devastated before the holidays

@MassGovernor, what say you?
And for those who argue cases don't matter any more, only hospitalizations and deaths - hospitalizations are at highest level since February, and today was the first day with 50+ deaths reported since March. So we are decidedly not "decoupled".
Read 4 tweets
Jon Levy Profile picture
17 Sep
1. Hi! Trained risk assessor here. Can we talk about this “1 in 5000” risk of getting #COVID19 if you are vaccinated, all of the things that are wrong with the number and how it is being used, and why I still think there is some value in the calculation? 🧵
2. First, for those unfamiliar, this first appeared (to my knowledge) in a column by @DLeonhardt in the @nytimes. He estimated a 1 in 5000 risk from stats in a few settings (UT, VA, WA). Let’s assume that his number is right. I still have a few major problems with it.
3. First, it is a daily risk, which is not how we commonly quantify risk. The column did say this directly, so it is not hidden from the reader, but many people dropped that nuance in talking about the number. Probably too much headline reading and not enough article reading.
Read 22 tweets
Jon Levy Profile picture
14 Sep
Anyone patting themselves on the back about how we have handled #COVID19 in MA should periodically look at this chart and the profound racial/ethnic disparities. #mapoli Image
Our analyses showed that communities with higher % Latinx populations had sustained elevations in case incidence across the first 8 months of the pandemic, even after controlling for other factors.

bmcinfectdis.biomedcentral.com/articles/10.11…
The Latinx population in MA also has among the lowest % vaccinated (56%) among racial/ethnic groups in the state.

mass.gov/doc/weekly-cov…
Read 5 tweets
Jon Levy Profile picture
25 Aug
1. Both MA and VT target 80% vaccination rate in schools to remove mask mandates. Let’s be clear that this isn’t about herd immunity. For one, 80% doesn’t get you there - if R0 = 6 for delta and vaccine efficacy is 90% (both generous assumptions), it would be 92.5%.
2. Also, a school isn’t a “herd” (though it sometimes feels like one). Students and staff go home and interact with people outside of school.
3. Pure speculation, but I would guess that 80% just felt like a reasonable target consistent with overall vaccination rates. And therefore unmasking is a “prize” for schools that hit the target.
Read 6 tweets
Jon Levy Profile picture
5 Aug
1. I've been frustrated with how #COVID19 cases among the vaccinated have been reported, and I feel like it can be done better. I'm not an expert in this space, but I wanted to toss out some thoughts to #epitwitter and see if some collective wisdom could emerge. 🧵
2. First, to be clear, this is about public presentation of data in the media, not optimal study design to determine vaccine efficacy. My premise: Reporting just number of "breakthrough" cases lacks context, and "breakthrough" cases divided by number vaccinated lacks meaning.
3. So what is meaningful? Starting with cases, I'd argue that new cases per 100,000 vaccinated vs. new cases per 100,000 unvaccinated is a good starting point. CA does this - for the past week, it was 7 for vaccinated and 33 for unvaccinated.

cdph.ca.gov/Programs/CID/D…
Read 12 tweets

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