Schools as health-related assets: The role of school physical, educational, and social environments in shaping children's resilience to temperature and fine particulate matter exposure in New York - Exposure to ambient heat and fine particulate matter (PM2.5) poses many health risks in children, with differences in risk due to differences in both environmental exposure and in susceptibility-related factors. For children, school characteristics may impact both exposure and susceptibility to environmental hazards, given that children ages 5-17 spend about 20% of their time in school. Additionally, differences in educational quality are documented, underscoring the health implications of incorporating the school context in epidemiologic studies of children. Yet, little is known about the extent to which the spatial distribution of school characteristics childhood morbidity. And, little is known about the extent to which the school context can play a role in shaping childhood susceptibility to outdoor environmental exposures. The proposed research seeks to explore relationships between school context, ambient environmental exposures, neighborhood sociodemographic context, and pediatric morbidity in New York State (NYS). The specific aims are to: (1) investigate spatial variations in school context indicators across NYS, analyzing co-occurrences with area-level social and demographic factors, and (2) Evaluate indicators of school physical, educational, and social context as modifiers of the association between ambient exposures (PM2.5 & temperature) and pediatric morbidity, while accounting for correlated neighborhood characteristics. A comprehensive dataset of pediatric emergency department visits and hospitalizations will be linked with fine-scale daily temperature and PM2.5 estimates, and school context data from multiple publicly available sources. Multiple analytic methods will be used, including machine learning for dimension reduction and spatial methods (Aim 1), and distributed lag nonlinear models in both a frequentist and spatial Bayesian framework (Aim 2). With >12 million health records across 15 years (2005-2019), analyses will be well-powered to evaluate these complex relationships. Findings can be used to inform investment in schools to protect pediatric health, aligning with the NIEHS’s priority research areas. The training plan, developed by Lisa Frueh, MPH (PI) and Jane E. Clougherty, MsC, ScD (sponsor), supports the research activities and training goals. Frueh (PI) will leverage research, training, and professional development resources at the Drexel University Dornsife School of Public Health, a leading public health university in the US which fosters interdisciplinary collaborative research. Together, the proposed research and training plan, supported by institutional resources and the mentorship team of Dr. Clougherty and interdisciplinary collaborators, will support the PI’s career goals.
