Graduation Date

Fall 12-15-2017

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Programs

Epidemiology

First Advisor

Lorena Baccaglini

Abstract

The relationship between human health and the environment is complex and overall poorly understood. The environment has a lasting impact on health, and the processes appear to start at conception. Thus, this dissertation examines the potential relationship between pediatric health and the environment.

The first relationship examined was between the built environment and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder. Many publications have reported the relationship between socioeconomic disadvantage, Attention Deficient Hyperactivity Disorder, and Autism Spectrum Disorder. However, the link between the built environment and Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder symptom severity is poorly understood. An analysis was conducted using the 2011/2012 National Children’s Health Survey accounting for the complex survey design. For children with insurance and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder, there was a limited association between symptom severity and neighborhood factors.

The second relationship examined was the potential relationship between the physical environment and pediatric health. This was completed by examining if there was an advantage in conducting geospatial analysis relative to congenital abnormalities and pediatric cancer, using watersheds, rather than anthropogenic census tracts, particularly concerning agrichemical runoff.

The last relationship examined in this dissertation was between the social environment and childhood health. Participation in extracurricular activities has been linked to higher educational motivation, achievement and high school graduation. However, the process by which this improvement occurs is poorly understood and has not been well examined in children who have developmental differences. The analysis was conducted using the 2011/2012 National Children’s Health Survey. Extracurricular activities and comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder diagnosis affected the odds of educational engagement. The findings suggest that the extracurricular activities have a positive effect on educational engagement regardless of comorbid Attention Deficient Hyperactivity Disorder and Autism Spectrum Disorder.

Overall, this dissertation found that the built, physical, and social environments appear to influence pediatric health.

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