The Humans in Human Ecology: Studying Society

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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
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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

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Data on Human Behavior

• Land/water use analysis, GIS
• Mapping of housing characteristics
• Surveys to quantify behavior
• Interviews and focus groups to characterize/descri
  be behavior

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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)

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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

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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

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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)

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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

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Need for New Models

• Few models of health behavior adequately account
  for role of local ecology in shaping peoples
  risk perception

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Personal knowledge about disease
Information Sources
Actions of local government
Local ecology
Locally-defined intensity of transmission
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Intense WNV Human Disease 2002 2003
WA
ME
VT
MT
ND
MN
NH
OR
NY
MA
WI
ID
SD
RI
WY
MI
Population perceives limited mosquito
infestation Limited experience w/ some
resistance to mosquito control Risk perception
linked to info from community groups
PA
NJ
CT
IA
NE
OH
DE
IN
NV
IL
UT
VA
WV
CO
CA
KS
MO
MD
KY
NC
TN
OK
AZ
SC
NM
AR
GA
AL
MS
TX
LA
FL
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
Includes Fever and neuroinvasive disease as
reported to CDC
gt 200 human cases 2003
gt 200 human cases 2002
gt 200 human cases both years
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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.

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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?
• Weve 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 weve got it made and were kind of
  invulnerable to any sort of thing.

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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.

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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 peoples concern
  over the issue.
• Can long-term mosquito abatement lead to
  complacency (and no repellent use) among
  citizens?
• Local govt actions can serve as trigger for
  citizens

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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

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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

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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