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In response to concerns expressed by community members, EJCAN launched a water quality testing initiative with university-based collaborators to increase knoweldge about the impacts of multiple hazards on water. Industrialized hog feces contain pathogens, heavy metals, and antibiotic-resistant bacteria that growers store in large, open pit lagoons (Grant 1999; Wing et al. 2008; Blanchette 2019; Christenson et al. 2022). When operators spray the waste onto nearby fields, they also release air and waterborne contaminants. Scholars have linked airborne emissions from industrial hog operations to respiratory dysfunction, mood disorders, compromised immune function, anemia, kidney disease, tuberculosis, and low birth weight (Wing et al. 2000; Kravchenko et al. 2018; Guidry et al. 2018). Moreover, the odor is noxious, causing nausea, embarrassment, disorientation, and social loss in cultural continuity as people cease culturally meaningful practices like gardening, going for walks, or gathering outside to share food (Herring 2014; Blanchette 2019). The impacts to water include contamination, harmful algal blooms, fish kills, and eutrophication in rivers and estuaries, especially when hurricanes flood the inner coastal plains with industrialized animal waste (Wing et al. 2000; Wing et al. 2008; NCCN 2021; Emanuel 2018; Christenson et al. 2022).Through Sampson County there is uneven access to water quality infrastructure, and residents have been advocating for improved access for water quality for more than a decade.   

The purpose of this study is to look at the effect of social and economic factors, status and health comunication behaviors on people's knowledge about the flu pandemic and prevention efforts. In the past it has been reflected in studies that people in different social groups have a far different access to information form each other about health and specific threats of diseases, which in effect may alter their behavior and knowledge on the topic. This study looks to see if these inequalities lead to a compromised  adversity in these vulnerable populations when it comes to responses to the flu outbreak. 

This article was published in Public Health Reports, this is the official journal of the US public Health Service and Surgeon General of the United States. Topics and issues of public health law, public health practice and research as well as schools and teaching are published in this journal. Overall, this journal is highly regarded. It is peer reviewed and publishes original work. Being the official journal of US departments reflects its validity. 

The methods utilized in this paper are not necessarily new or inventive, yet this doesn't detract from its effectiveness. The data used for this study was collected from surveys of 1,569 people and the data was then analyzed using statistical methods of logistic regression.

This paper has been cited and discussed in 7 different articles according to Google Scholar. Many of the papers it has been cited in have to do with the effects of social media on opinions of opioid use, gun violence, vaccination rates and more. The papers all have to do with public perception and education on certain topics, very similar to this study.

Professionals can use this data to better equip themselves with the knowledge of weaknesses of the masses, in terms of what they know or don't know and what they perceive about the Influenza epidemic. Professionals can better identify where most people receive their data from and where they are most likely to get their information from. This will allow professionals to better identify vulnerable groups and better prepare those areas and groups, sculpting educational programs and informational/educational forums and outlets to them, with the hopes of increasing public health efforts.

Through the use of surveying, this study identified that there are in fact inequalities in people's understanding of proper responses to pandemic influenza outbreaks. This study helped identify these vulnerable groups, and that social media and forms of mass media are the main ways to reach these groups. To address this vulnerable population, the public needs an increased accessibility to information, overall increasing the public's level of knowledge about the pandemic.

The funding for this study came from the Centers for Disease Control and Prevention (CDC), grant number #5PO1TP000307-05.  

charts like this only show how any are in poverty.  whats not shown is how these people and families got to this point and what the common theme is between them