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Background: Billions of dollars have been spent implementing regulations to reduce traffic-related air pollution (TRAP) from exhaust pipe emissions. However, few health studies have evaluated the change in TRAP emissions and associations with infant health outcomes. We hypothesize that the magnitude of association between vehicle exposure measures and adverse birth outcomes has decreased over time, parallelling regulatory improvements in exhaust pipe emissions., Methods: Using birth records in Texas from 1996 to 2016, we calculated residential exposure measures related to TRAP: nitrogen dioxide (NO2, a marker of the TRAP mixture), vehicle miles travelled within 500 m of homes (VMT500), a measure of traffic volume, and highway proximity. Using an accountability study framework, our analysis examined term birthweight, term low birthweight (TLBW) (<2500 g), preterm birth (PTB) (<37 weeks) and very preterm birth (VPTB) (<32 weeks). We implemented linear and logistic regression models to examine overall and time-stratified associations, including trends by race/ethnicity and socioeconomic groups., Results: Among exposures for 6 158 518 births, NO2 exposures decreased 59% over time but VMT500 remained relatively stable. TRAP-related exposure measures were persistently associated with harmful birth outcomes [e.g. OR1996-2016 of 1.07 (95% CI: 1.04, 1.08) for TLBW comparing the highest vs lowest NO2 quintile]. The magnitude of associations decreased for total VMT500 and TLBW (-60%, OR1996: 1.08 to OR2016: 1.03 for the highest vs lowest quintile) and PTB (-65%) and VTPT (-61%), but not for term birthweight., Conclusions: We observed evidence of small improvements in birth outcomes associated with reductions in exhaust pipe emissions over a 20-year period in Texas., (© The Author(s) 2025. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Traffic-related air pollution (TRAP) poses a significant public health risk that is associated with adverse birth outcomes. Large roadway infrastructure projects present a natural experiment to examine how resulting congestion change is associated with adverse birth outcomes for nearby populations. This study is designed to examine the influence of living close to a roadway before, during, and after a construction project using a difference-in-differences design. We integrated data on all large roadway construction projects (defined as widening of existing roads, building new roads, improving bridges, installing intelligent transportation systems, improving intersections, and installing or upgrading traffic signals) in Texas from 2007 to 2016 with Vital Statistic data for all births with residential addresses within 1 km of construction projects. Our outcomes included term low birth weight, term birth weight, preterm birth, and very preterm birth. Using a difference-in-differences design, we included births within 3 years of construction start and 2 years of construction end. In our main model, the exposed group is limited to pregnant individuals residing within 300 m of a construction project, and the control group includes those living within 300-1000 m from a project. We used regression models to estimate the influence of construction on infant health. We included 1,360 large roadway construction projects linked to 408,979 births. During construction, we found that the odds of term low birth weight increased by 19% (95% CI: 1.05, 1.36). However, we saw little evidence of an association for other birth outcomes. Contrary to our hypothesis of decreased TRAP after construction ends, we did not observe consistent improvements post-construction for pregnant individuals living within 300 m. Continued consideration of the influence of traffic congestion programs on birth outcomes is necessary to inform future policy decisions., Competing Interests: Declaration of competing interest All authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Traffic-related air pollution (TRAP) is an established health hazard, and roadway construction has the potential to affect TRAP by relieving congestion. The relationship between roadway construction and congestion is of policy importance, but few studies examine it using large samples of construction projects and detailed traffic and air pollution data. We create a dataset of construction projects in Texas and link them to data on air pollution and three variables operationalizing congestion: average annual daily traffic (AADT), AADT per lane, and delay in hours. We use difference-in-difference methods to estimate the effect of widening and intersection improvements on congestion and air pollution. On average over the period during construction, we find that widening increases delay by 42% (95% CI: 30, 56%), but intersection projects do not affect delay. On average and over the first three years post-construction, we find that widening reduces delay by 33% (95% CI: -41, -24%) and reduces NO 2 levels within 500 m by 13% (95% CI: -22, -2%), and intersection projects reduce delay by 52% (95% CI: -65, -35%) and reduce NO 2 levels within 500 m by 12% (95% CI: -18, -5%). These short-term impacts are relevant for understanding the impact of roadway construction on human health., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Perry Hystad reports financial support was provided by Health Effects Institute., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Importance: Air pollution presents clear environmental justice issues. However, few studies have specifically examined traffic-related air pollution (TRAP), a source driven by historically racist infrastructure policies, among pregnant individuals, a population susceptible to air pollution effects. How these disparities have changed over time is also unclear but has important policy implications., Objective: To examine changes in TRAP exposure by sociodemographic characteristics among recorded pregnancies over a 20-year period., Design, Setting, and Participants: This population-based birth cohort study used descriptive analysis among pregnant individuals in Texas from 1996 to 2016. All pregnant individuals with valid residential address, socioeconomic, and demographic data were included. Individual-level race and ethnicity, education, and maternal birthplace data were extracted from birth certificates and neighborhood-level household income and historical neighborhood disinvestment (ie, redlining) data were assessed via residential addresses. Data analysis occurred between June 2022 and June 2023., Main Outcomes and Measures: The main outcome, TRAP exposure at residential addresses, was assessed via traffic levels, represented by total and truck-specific vehicle miles traveled (VMT) within 500 m; nitrogen dioxide (no2) concentrations from a spatial-temporal land use regression model (ie, vehicle tailpipe emissions); and National Air Toxic Agency cancer risk index from on-road vehicle emissions. TRAP exposure differences were assessed by sociodemographic indicators over the 1996 to 2016 period., Results: Among 7 043 598 pregnant people (mean [SD] maternal age, 26.8 [6.1] years) in Texas from 1996 to 2016, 48% identified as Hispanic or Latinx, 4% identified as non-Hispanic Asian or Pacific Islander, 12% identified as non-Hispanic Black, and 36% identified as non-Hispanic White. There were differences in TRAP for pregnant people by all sociodemographic variables examined. The absolute level of these disparities decreased from 1996 to 2016, but the relative level of these disparities increased: for example, in 1996, non-Hispanic Black pregnant individuals were exposed to a mean (SD) 15.3 (4.1) ppb of no2 vs 13.5 (4.4) ppb of no2 for non-Hispanic White pregnant individuals, compared with 2016 levels of 6.7 (2.4) ppb no2 for Black pregnant individuals and 5.2 (2.4) ppb of no2 for White pregnant individuals. Large absolute and relative differences in traffic levels were observed for all sociodemographic characteristics, increasing over time. For example, non-Hispanic Black pregnant individuals were exposed to a mean (SD) of 22 836 (32 844) VMT within 500 m of their homes, compared with 12 478 (22 870) VMT within 500 m of the homes of non-Hispanic White pregnant individuals in 2016, a difference of 83%., Conclusions and Relevance: This birth cohort study found that while levels of air pollution disparities decreased in absolute terms over the 20 years of the study, relative disparities persisted and large differences in traffic levels remained, requiring renewed policy attention.

Background: Evidence-based fall prevention programs primarily attract older women, who are increasingly burdened by fall-related injuries. However, little is known about the relationship between older female participants' baseline health status and self-reported falls over the course of fall prevention interventions. Using data from A Matter of Balance/Volunteer Lay Leader Model (AMOB/VLL) workshops, this study examines female participants' sociodemographics and health indicators associated with self-reported falls at baseline and postintervention., Methods: Data were analyzed from 837 older women (M = 76.2 years) collected during the statewide AMOB/VLL dissemination in Texas. Longitudinal Poisson regression models, using the generalized estimating equation method, were used to investigate the associations of personal characteristics and health indicators with and reductions in the number of self-reported falls from baseline to postintervention., Findings: Approximately 21% of participants reported falling at baseline, and the number of reported falls significantly decreased from baseline to postintervention (β = -0.443). At baseline, more unhealthy physical days (β = 0.022), more unhealthy mental days (β = 0.018), and lower Falls Efficacy Scale scores (β = -0.052) were significantly associated with more falls reported at baseline. More falls at baseline was also associated with worse program attendance (β = -0.069). Greater improvements in Falls Efficacy Scale Scores (β = -0.069) and decreases in unhealthy physical health days (β = 0.026) over the course of the intervention were significantly associated with greater reductions in reported falls at postintervention, respectively., Conclusions: Findings have implications for identifying at-risk older women upon enrollment, expanding the reach of AMOB/VLL, and leveraging AMOB/VLL to refer participants to other evidence-based exercise, disease management, and mental health interventions., (Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.)

This study examines middle-aged and older women's smoking practices and identifies factors associated with tobacco use and cessation in this population. Data of 593 women were analyzed from a seven-county random household sample in Texas. Sequential multinomial logistic regression compared associations with having never smoked, having quit smoking, and currently smoking. Compared to smokers, never smokers and past smokers were significantly more likely to be older, more educated, of better general health, and report past-year physician visits and fewer depressive symptoms. Mental health and smoking are interrelated, indicating the need for addressing depression in smoking-cessation efforts for aging women.