the humans in human ecology: studying society & west nile virus
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The Humans in Human Ecology: Studying Society & West Nile Virus. Emily Zielinski Gutierrez, CDC/Division of Vector-Borne Infectious Diseases Mary Hayden, University of Colorado at Colorado Springs. NISSC. Human Ecology & Vector-borne Disease. - PowerPoint PPT PresentationTRANSCRIPT
The Humans in Human Ecology:
Studying Society & West Nile Virus
Emily Zielinski Gutierrez,
CDC/Division of Vector-Borne Infectious Diseases
Mary Hayden,
University of Colorado at Colorado Springs
NISSC
Human Ecology & Vector-borne Disease
• People shape local ecology and thus influence vector ecology– Land use and sanitary conditions (trash, breeding
sites)– Control of water resources
• Human patterns and choices affect exposure to vectors– Housing characteristics– Outdoor activities (work & recreation)– Use of prevention measures
Data on Human Behavior
• Land/water use analysis, GIS
• Mapping of housing characteristics
• Surveys to quantify behavior
• Interviews and focus groups to characterize/describe behavior
Qualitative/Quantitative Methods
• Qualitative Data– Often “words”– Inductive– Not intended to be
generalizable– Identify concepts,
issues– How? Why?– Subjective
• Quantitative Data– Often “numbers”– Deductive– Usually generalizable
– Identify frequency/magnitude
– What? How many? – “Objective” (but…)
Qualitative and Quantitative Methods
• Both “scientific,” though from varied disciplines• Role of researcher can vary
– level of involvement, interaction• Ultimately depends on the question(s) you are
trying to answer– Ideally function as complementary approaches to
analysis• Resources
– Qualitative MAY be quicker, cheaper and administratively easier (IRB, OMB) – rapid assessment
Methods – WNV focal areas
• Community discussion groups (e.g. focus groups) – Louisiana (2002), Colorado (2003), Illinois (2003),
California/Mexico border (2004) – Demographically diverse populations– Focus groups were segmented by age, language,
ethnicity/race, and geographic location.
• Interviews transcribed and content analysis conducted to define major themes and interactions
Data Collection
• Topics covered:– concern/risk perception vis-à-vis WNV,
mosquitoes– attitudes towards mosquitoes, repellent, and
mosquito control– information sources– protective actions (repellent, protective
clothing, screening)– housing & lifestyle (e.g., time spent outdoors)
Synthesis
Risk perception was affected by locally- and individually-defined “intensity of WNV transmission”
Factors defining local intensity of transmission include: • personal knowledge about disease • type and credibility of information sources• local government intervention• perception of local ecology
Need for New Models
• Few models of health behavior adequately account for role of local ecology in shaping people’s risk perception
Personal knowledge about diseaseInformation Sources
Locally-defined intensity of transmission
Local ecologyActions of local government
Intense WNV Human Disease 2002 & 2003
WA
OR
CA
MT
ID
NV
WY
COUT
AZ NM
TX
ND
SD
NE
KS
OK
MN
IA
MO
AR
LA
MSAL GA
FL
TNSC
NC
VAIL
WIMI
IN OH
KYWV
PA
MD
DENJ
NY
CTRIMANH
MEVT
> 200 human cases 2003
> 200 human cases 2002
> 200 human cases both years
Includes Fever and neuroinvasive disease as reported to CDC
Long history of mosquito infestations and nuisance
Experience with and general support for mosquito control as a public service
Risk perception linked to info from community groups
Population perceives limited mosquito infestation
Limited experience w/ & some resistance to mosquito control
Risk perception linked to info from community groups
Risk: personal knowledge of disease
• Knowing some who was ill– Increased recognition of WNV Fever cases during
2003*, more residents knew of someone infected
• Concern about severity of Fever– Not the same impact as ND, but people missed
school, work, described prolonged headache ache and fatigue
• “No one told us it was going to be this bad.”
Defining Risk: Local Ecology
• “No mosquitoes here”: West– Public lack recent history of dealing with mosquitoes
as a nuisance or comparisons to Midwest/elsewhere– We have a drought, how can we have mosquitoes?
• “We’ve always had mosquitoes…”: South• Home as “Safe Zone”
– Forget repellent in the backyard… disinclination to regard home as dangerous
• “Most of us [retirees] who are living here are so happy to be in this particular environment that we think we’ve got it made and… we’re kind of invulnerable to any sort of thing.”
Defining Risk: perception of ecology/local geography
• “Hyper-localization” of risk– Individuals try to quantify exactly where and
when the risk exists• We know that (on the whole) Americans have
poor geography skills • People try to downgrade their risk – e.g. that dead
bird was 3 blocks from here…• “We hear about the deaths… I wish they would go
into a bit more history [of where they were bit.]”
Defining risk: people look at what government is doing
• Mosquito control actions can create controversy. • The decision to declare a public health emergency also was
noted as influencing people’s concern over the issue.
• Can long-term mosquito abatement lead to complacency (and no repellent use) among citizens?
• Local gov’t actions can serve as trigger for citizens
Social Factors Potentially Influencing WNV Risk
• Community Level: – History/use of mosquito abatement– Irrigation practices– Land Use (farming, golf courses…)– Presence of household breeding (trash
collection, tire laws, gardening practices)– Regional adaptation to climate
Social Factors Potentially Influencing WNV Risk
• Household/Personal Level– Presence/lack of air conditioning (vs. swamp
coolers vs. fans vs. none)– Style of housing (open vs. closed)– Type of work (e.g. ag workers, landscaping)– Recreation choices (gardening, golf)– Willingness to engage in repellent use, control
of breeding sites • May depend on experience with other public health
progs, risk perception…
Recommendations
• Short-term:– Educate citizens on local ecology– Help people interpret data through mapping– Housing adaptations, target certain populations with
education on risk mitigation
• Long-term: – Examine factors that influence mosquito breeding &
resistance to control (household and ag irrigation, ag use of pesticides)
• Work toward policy changes