Date on Master's Thesis/Doctoral Dissertation

8-2022

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Epidemiology and Population Health

Degree Program

Public Health Sciences with a specialization in Epidemiology, PhD

Committee Chair

DuPre, Natalie

Committee Co-Chair (if applicable)

Taylor, Kira

Committee Member

Taylor, Kira

Committee Member

Guinn, Brian

Committee Member

Yeager, Ray

Committee Member

Gskins, Jeremy

Author's Keywords

environmental noise; mental health; depression; standardized test; land use regression; disparities

Abstract

Background and Aim: The current body of literature on the associations of environmental noise exposure with varying psychological outcomes is inconclusive, with many conflicting findings. Limitations include exposure measurement error and lack of investigation of effect modification by important factors. This dissertation aims to expand on the current understanding of these relationships by limiting exposure measurement error and by assessing effect modification. Methods: We estimated the distribution of total environmental noise in Louisville, Kentucky for several time-periods using land use regression (LUR) methodologies. Additionally, through multiple regression models, we estimated the association of environmental noise during relevant time-periods with childhood cognition using standardized testing scores at the school-level, and mental health outcomes of adults at the census-tract and individual levels. We assessed effect modification of these associations by several demographic, socioeconomic, and health behavioral factors. Data linkage of several sources was utilized throughout analyses. Results: Environmental noise in Louisville was louder in areas where the majority of the population is non-white or lower income. Generally, louder noise was not associated with school-level standardized testing scores. At the census-tract level, louder noise was significantly associated with higher prevalence of mental ill-health. Also, individuals with the loudest environmental noise exposures had significantly higher odds of depression than those exposed to the quietest exposures. However, results suggest that socioeconomic and health behavioral factors – like race, income, stress, and sleep – may confound or modify these associations. Findings suggest that white, higher income, and less stressed individuals living within louder, less-white, low-income, high-stress areas are the most negatively impacted by louder environmental noise in relation to psychological outcomes. Conclusion: Non-white, lower income, and more stressed individuals living within these areas may have higher baseline allostatic loads, such that the effects of louder noise may be negligible. However, noise mitigation efforts will need to be implemented at large, neighborhood levels to effectively break the cycle of environmental health disparities from environmental noise, especially among underserved Louisville communities that endure the loudest environmental noise exposures.

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