Adverse Childhood Events and Their Association with Adverse Health Outcomes: A Sacramento County (California) Study

Adverse Childhood Events (ACEs) may negatively impact mental, emotional, and physical health. The study’s main goal was to understand ACEs and associated adverse health outcomes, specifically focusing on the ACE exposures to Sacramento County residents. Sacramento County was chosen as it includes a big metropolitan community of about 1.5 million people. PubMed was used to identify research articles on the correlation between ACEs and adverse health outcomes during adulthood, and the disparities in healthcare services provided to County residents. Generally, the results demonstrate that ACEs are associated with a range of negative health outcomes. There is a need for interventions to mitigate the adverse impact that ACEs have on the health of both pediatric and adult populations. Studies indicate that County residents have a high probability of experiencing an ACE exposure or a set of circumstances that exacerbate the effect of ACEs. Some examples of ACEs specific to residents include low socioeconomic status or severe economic hardship, medical trauma, household dysfunction, discrimination, hunger, limited resource accessibility, and poor mental health. Despite the incomplete knowledge on ACEs from a biological standpoint, unpredictable range of ACE health outcomes, and non-standardized treatment protocols, data support that ACEs adversely impact the health status of residents, and studies support intervention.

Assessment of Ambient Air Toxics and Wood Smoke Pollution among Communities in Sacramento County

Ambient air monitoring and phone survey data were collected in three environmental justice (EJ) and three non-EJ communities in Sacramento County during winter 2016–2017 to understand the differences in air toxics and in wood smoke pollution among communities. Concentrations of six hazardous air pollutants (HAPs) and black carbon (BC) from fossil fuel (BCff) were significantly higher at EJ communities versus non-EJ communities. BC from wood burning (BCwb) was significantly higher at non-EJ communities. Correlation analysis indicated that the six HAPs were predominantly from fossil fuel combustion sources, not from wood burning. The HAPs were moderately variable across sites (coefficient of divergence (COD) range of 0.07 for carbon tetrachloride to 0.28 for m- and p-xylenes), while BCff and BCwb were highly variable (COD values of 0.46 and 0.50). The BCwb was well correlated with levoglucosan (R2 of 0.68 to 0.95), indicating that BCwb was a robust indicator for wood burning. At the two permanent monitoring sites, wood burning comprised 29–39% of the fine particulate matter (PM2.5) on nights when PM2.5 concentrations were forecasted to be high. Phone survey data were consistent with study measurements; the only significant difference in the survey results among communities were that non-EJ residents burn with indoor devices more often than EJ residents.

Prevalence and Associated Risk Factors of Diabetes in the African Immigrant Population of Sacramento County, California

Purpose The purpose of this study was to determine the prevalence and associated risk factors of diabetes in the African immigrant population in Sacramento County, California. Methods A cross-sectional study was conducted in Sacramento County, California, from June to August 2018. The convenience sample included 126 African immigrants aged 21 years and older. Sociodemographic and clinical characteristics were collected. Hemoglobin A1C (A1C) level, blood pressure, height, and weight were measured per standard methods. Data were analyzed using descriptive statistics and χ2 test at value of P < .05. Results Of 126 adult individuals included in this study, 32 (25.4%) had diabetes, of whom 25 (19.8%) were previously diagnosed and 7 (5.6%) represented new cases of diabetes. Also, 36 (28.6%) had prediabetes, of whom 24 (19.1%) had previously been told they had prediabetes and 12 (9.5%) represented new cases of prediabetes. Diabetes and prediabetes were significantly higher among participants in the age group of 36 to 60 years, married, employed full-time, and those with hypertension, high blood cholesterol, and participating in 0 to 2 days per week of moderate physical activities. Only one-fifth of all participants with previously known diabetes or previously on treatment had a good glycemic control status. Conclusions The present study found a high prevalence of prediabetes, diabetes, and multiple risk factors of diabetes in the African immigrant population, as well as a poor glycemic control among those with diabetes, calling for urgent attention. Strategies aimed to improving a healthy lifestyle in the African immigrant population are necessary to reduce the burden of diabetes.

Anti-Crime Laws and Retail Prices

The fear of becoming a victim of crime acts as a barrier to retail trade for consumers, where retailers attempt to reduce such barriers by enduring additional costs such as insurance or security/surveillance; as a result, retail prices are affected by the possibility of crime. This paper attempts to measure such effects by considering the recent experience of Sacramento County in California, where an anti-panhandling ordinance has been issued to protect retailers. As an application, a difference-in-difference approach is employed to identify the effects of the ordinance on Sacramento gasoline prices at the retail level, by considering the gasoline prices in neighboring counties as the control group of a natural experiment. The results show that the anti-panhandling ordinance has resulted in lower gasoline prices in Sacramento County.

Characterization of Streptomycin Resistance in Isolates of Erwinia amylovora in California

In surveys from 2006 to 2014, streptomycin resistance in Erwinia amylovora from pear-growing areas in California declined from very high incidence in 2006 and 2007 to very low incidence in 2013 and 2014. The majority of resistant strains were designated as moderately resistant-low (MR-L), and were almost exclusively found in Sacramento County, whereas highly resistant (HR) strains were only recovered in Sutter-Yuba and San Joaquin counties. Resistance of HR strains was associated with a mutation in codon 43 of the chromosomal rpsL gene that results in a change from lysine to arginine, the same mutation that was originally reported for resistant strains from California in the mid-1970s. MR-L strains were found to harbor the strA-strB streptomycin resistance genes on transposon Tn5393a. This transposon lacks insertion sequence IS1133 that provides a promoter for efficient expression of strA-strB, resulting in lower minimum inhibitory concentrations of MR-L strains compared with those from other locations that harbor strA-strB on Tn5393::IS1133. In contrast to previously described plasmid-mediated resistance where Tn5393 is inserted in pEa34, or pEA29, Tn5393a in MR-L strains was located on plasmid pEU30. This plasmid was first described in E. amylovora from the western United States but was not associated with streptomycin resistance determinants previously. We hypothesize that Tn5393a was introduced into an E. amylovora strain carrying pEU30 and transposed into that plasmid. This hypothesis was supported by clustered regularly interspaced short palindromic repeat (CRISPR) sequence analysis that showed that two MR-L strains share the same CRISPR1 pattern as a streptomycin-sensitive strain. With current low resistance levels in California growing regions, streptomycin could be successfully used again, but applications per season should be limited and the antibiotic should be mixed and rotated with different modes of action.