Lauren B. Anderson, Heather D. Ness, Rochelle H. Holm, and Ted Smith are with the Christina Lee Brown Envirome Institute, School of Medicine, University of Louisville, Louisville, KY. L. B. Anderson is also with the Department of Urban and Public Affairs, College of Arts and Sciences, University of Louisville. H. D. Ness is also with the Department of Health Promotion and Behavioral Sciences, School of Public Health and Information Sciences, University of Louisville.