'Sharing things with people that I don't even know': help-seeking for psychological symptoms in injured Black men in Philadelphia

Objectives: Psychological distress is common in survivors of traumatic injury, yet across United States' trauma systems, it is rare that standard injury care integrates psychological evaluation and professional mental healthcare. The purpose of this study was to explore help-seeking for psychological symptoms in injured Black men living in Philadelphia. Design: A subset of a cohort of 551 injured Black men admitted to a Trauma Center in Philadelphia participated in qualitative interviews that explored their perceptions of psychological symptoms after injury and the factors that guided their decision to seek professional mental health help. Data from 32 participants were analyzed for narrative and thematic content. Results: Three overarching themes emerged: (1) facilitators of help-seeking, (2) barriers to help-seeking, and (3) factors underlying the decision not to consider professional help. Five participants felt that their injury-related psychological distress was severe enough to merit professional help despite any perceived barriers. Seventeen participants identified systemic and interpersonal obstacles to professional help that prevented them from seeking this kind of care. These included: financial constraints, limited access to mental healthcare services, and fear of the judgments of mental healthcare professionals. Ten participants would not consider professional help; these men perceived a lack of need and sufficiency in their existing social support networks. Conclusions: Research is needed to inform or identify interventions that diminish the impact of barriers to care, and identify from whom, where, and how professional mental health help might be more effectively offered to injured Black men in recovery environments like Philadelphia.

Outcome of donor lymphocyte infusion for fall in chimerism after hematopoietic stem cell transplant

Achievement of complete donor chimerism after an allogeneic hematopoietic stem cell transplant is necessary for elimination of underlying malignant disease. A decline in donor chimerism may herald an impending relapse and therefore, early recognition and intervention plays an important role in such cases. A 32 year old male patient diagnosed as a case of Philadelphia positive mixed phenotypic acute leukaemia underwent peripheral blood hematopoietic stem cell transplant (HSCT) with his sibling as donor. During follow-up, a fall in donor chimerism was observed from 91.86% on day +37 to 88.83% on day +57 and 85.34% on day +77. Donor Lymphocyte Infusion (DLI) was harvested via apheresis. A dose of 1 × 10⁶ per kg was infused and the rest was cryopreserved in aliquots of escalating doses. On day +102, he presented with biopsy proven acute mucocutaneous GVHD grade 2 which was managed conservatively and donor chimerism of 57.99%. On day +126, a repeat donor chimerism was performed which showed 100% chimerism. He continues to do well at day +161. Timely use of DLI can improve donor chimerism in patients with Philadelphia positive acute leukaemia who tend to relapse after HSCT.

Mobile monitoring of air and noise pollution in Philadelphia neighborhoods during summer 2017

Mobile monitoring is a useful approach for measuring intra-urban variation of air pollution in urban environments. In this study, we used a mobile monitoring approach to study the spatial-temporal variability of air and noise pollution in urban neighborhoods of Philadelphia. During summer 2017, we used portable instruments to measure PM_2.5, black carbon (BC), and noise levels along 5 km paths in four residential neighborhoods (Tioga, Mill Creek, Chestnut Hill, and Northern Liberties) and one commercial district (Center City) in Philadelphia, Pennsylvania, USA. A total of 62 sets of measurements were made at three different times of day (during morning rush hour, mid-afternoon, and during afternoon rush hour) from June 5 to July 7, 2017. Spatially, there was a significant difference in PM_2.5 concentrations among the four residential neighborhoods. Overall, the Chestnut Hill neighborhood had the highest PM_2.5 concentrations (13.25 ± 6.89 μg/m³), followed by Tioga (9.58 ± 4.83 μg/m³), Northern Liberties (7.02 ± 4.17 μg/m³), and Mill Creek (3.9 ± 4.5 μg/m³). There was temporal variability of pollutants depending on the neighborhood; Northern Liberties demonstrated the highest temporal variability in these data. The highest PM_2.5 (18.86 ± 3.17 mg/m³) was measured in the Chestnut Hill neighborhood during mid-afternoon. Mean PM_2.5, BC, and noise levels based on mobile measurements at Philadelphia during summer 2017 were 8.41 ± 4.31 μg/m³, 0.99 ± 0.44 μg C/m³, and 62.01 ± 3.20 dBA, respectively. Environmental noise showed the highest temporal variation of the monitored components for 3 time periods. In general, tree cover showed a weak and inconclusive association with particulate pollution levels.

Impact of population change and unemployment rate on Philadelphia's waste disposal

Predicting waste disposal of a given municipality could be complicated and expensive for government agencies. Lack of a uniform modeling approach, the gap between the scientific community and the government, inaccessibility to the forecasts of variables used in the waste management literature, and budget deficiencies could all result in over-simplification and possibly employing inaccurate modeling approaches for decision makers. This paper portrays the trend of Total Solid Waste (TSW) and Municipal Solid Waste (MSW) disposal of Philadelphia (Pennsylvania, US) with respect to the rate of population change, unemployment rate change, and the current recycling policies. The objective is to develop satisfactory predictive models for the TSW disposal using the same number of variables as currently used by the City of Philadelphia. It is crucial to include an economic factor such as unemployment rate in modeling the waste disposal, especially during economic downturns when economic factors can dominate the effects of population change on waste generation and therefore disposal. Two predictive models are developed using time series analysis and stationary multiple linear regression. The stationary multiple linear regression model yields more accurate predictions for both TSW and MSW disposal of Philadelphia with an approximate level of 8.8% Root Mean Square Percentage Error (RMSPE) and R² of 0.7. Even the VAR model, with RMSE of 0.15 million tons (RMSPE = 10.7%), provides better estiamtions than does the City of Philadelphia's current working model.

Comparing Urban Maxillofacial Trauma Patterns to the National Trauma Data Bank©

OBJECTIVES

We aimed to determine whether certain maxillofacial fracture patterns and injury mechanisms were more prevalent in an urban environment. In addition, we aimed to determine if maxillofacial trauma incidence correlated with income.

METHODS

Data was collected from Einstein Healthcare Network and Temple University Health System. These data were compared to the 2016 National Trauma Data Bank© (NTDB©) using chi-square analysis. Multivariate analysis was used to identify correlations between demographic variables and fracture patterns. Sociodemographic data was further characterized utilizing neighborhood mapping.

RESULTS

A total of 252 patients from our urban campuses and 14 447 patients from the NTDB© were identified with facial fractures. Maxillofacial trauma patients in the urban population were more likely to be minorities and less likely to be Caucasian compared to the NTDB© (P < .001). Patients in the urban setting were more likely to sustain mandibular and orbital fractures, and less likely to sustain maxillary fractures and multiple fractures (P < .001). Urban maxillofacial trauma patients were more likely to sustain assault and sporting injuries, and less likely to sustain injuries from motor vehicle accidents and self-harm (P < .001).

CONCLUSIONS

Maxillofacial trauma patterns and injury mechanisms were shown to be significantly different in an urban environment as compared to national data.

Association of Enterovirus D68 with Acute Flaccid Myelitis, Philadelphia, Pennsylvania, USA, 2009-2018

Acute flaccid myelitis (AFM) is a polio-like disease that results in paralysis in previously healthy persons. Although the definitive cause of AFM remains unconfirmed, enterovirus D68 (EV-D68) is suspected based on 2014 data demonstrating an increase in AFM cases concomitant with an EV-D68 outbreak. We examined the prevalence in children and the molecular evolution of EV-D68 for 2009–2018 in Philadelphia, Pennsylvania, USA. We detected widespread EV-D68 circulation in 2009, rare detections in 2010 and 2011, and then biennial circulation, only in even years, during 2012–2018. Prevalence of EV-D68 significantly correlated with AFM cases during this period. Finally, whole-genome sequencing revealed early detection of the B1 clade in 2009 and continued evolution of the B3 clade from 2016 to 2018. These data reinforce the need to improve surveillance programs for nonpolio enterovirus to identify possible AFM triggers and predict disease prevalence to better prepare for future outbreaks.

Mycobacterium avium in Community and Household Water, Suburban Philadelphia, Pennsylvania, USA, 2010-2012

Attention to environmental sources of Mycobacterium avium complex (MAC) infection is a vital component of disease prevention and control. We investigated MAC colonization of household plumbing in suburban Philadelphia, Pennsylvania, USA. We used variable-number tandem-repeat genotyping and whole-genome sequencing with core genome single-nucleotide variant analysis to compare M. avium from household plumbing biofilms with M. avium isolates from patient respiratory specimens. M. avium was recovered from 30 (81.1%) of 37 households, including 19 (90.5%) of 21 M. avium patient households. For 11 (52.4%) of 21 patients with M. avium disease, isolates recovered from their respiratory and household samples were of the same genotype. Within the same community, 18 (85.7%) of 21 M. avium respiratory isolates genotypically matched household plumbing isolates. Six predominant genotypes were recovered across multiple households and respiratory specimens. M. avium colonizing municipal water and household plumbing may be a substantial source of MAC pulmonary infection.

Muslim-Non-Muslim Locational Attainment in Philadelphia: A New Fault Line in Residential Inequality?

This study examines Muslim-non-Muslim disparities in locational attainment. We pool data from the 2004, 2006, and 2008 waves of the Public Health Management Corporation's Southeastern Pennsylvania Household Survey. These data contain respondents' religious identities and are geocoded at the census-tract level, allowing us to merge American Community Survey data and examine neighborhood-level outcomes to gauge respondents' locational attainment. Net of controls, our multivariate analyses reveal that among blacks and nonblacks, Muslims live in neighborhoods that have significantly lower shares of whites and greater representations of blacks. Among blacks, Muslims are significantly less likely than non-Muslims to reside in suburbs. The Muslim disadvantages for blacks and nonblacks in neighborhood poverty and neighborhood median income, however, become insignificant. Our results provide support for the tenets of the spatial assimilation and place stratification models and suggest that Muslim-non-Muslim disparities in locational attainment define a new fault line in residential stratification.

Public Transit and School Choice in Philadelphia: Exploring Spatial Equity and Social Exclusion

This paper explores the importance of considering transportation mode when calculating commute time for a child's school choice options. While proponents of school choice argue that students can attend any school that will provide them the best education, several have argued that commute time is as important for families as a school's characteristics. However, research to date models commute time using either distance as a proxy or minutes driving. In Philadelphia, a context where most people use public transportation to work and school, the authors argue that commute time to school must be calculated using this mode of transit. Using geospatial network analyses, the authors create choice sets for each neighborhood public high school. They first calculate the commute time between each zoned public high school and each public high school choice in the city by driving and by using public transportation. These two sets of commute times are then evaluated for the differences. The authors then calculate choice sets based on the average commute time in the city based on both modes of transportation. Finally, they compare the choice sets for each service area for spatial equity of public school quality. Findings indicate that the commute times between driving and public transportation are statistically different. Furthermore, public school choice sets within Philadelphia are spatially equitable, although the overall school quality needs improvement. The paper concludes with policy implications and recommendations for future research.

Are gentrifying neighborhoods more stressful? A multilevel analysis of self-rated stress

Gentrification, the increase of affluent residents into low-income neighborhoods, is thought to heighten self-rated stress, especially for residents of color. However, the relationship between gentrification and stress has not been directly measured. This study took advantage of the 2008 and 2010 waves of the Public Health Management Corporation’s Southeastern Pennsylvania Household Health Survey, the 2000 Census, and the 2006–2010 American Community Survey to investigate the relationship of gentrification to above-average self-rated stress. We paid attention to how racial/ethnic differences in gentrification may uniquely affect stress. We also measured factors associated with gentrification with implications for one’s stress including housing cost insecurity and community connection. Using multilevel modeling, we found that gentrifying tracts marked by increases in White residents and declines in non-Whites were more likely to report above-average stress. This study provides evidence that gentrification is related to stress, emphasizing the important role racial/ethnic change has in this process. These findings call for research to unpack the causal mechanisms through which gentrification affects stress.

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Gentrification associated with increases in White residents and decreases in nonwhite residents was related to stress.

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While Black residents overall were less likely to report stress, this relation went away in White gentrifying neighborhoods.

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The increase of neighborhood stability in White gentrifying neighborhoods was related to stress.

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Housing cost insecurity was associated with stress, though its direct relation to gentrification appeared limited.

Racial and Ethnic Trends in Prostate Cancer Incidence and Mortality in Philadelphia, PA: an Observational Study

BACKGROUND

To learn more about local prostate cancer (PCa) disparities, we conducted descriptive analyses of the role of race and age in PCa using the Pennsylvania Cancer Registry data for Philadelphia (2005-2014).

METHODS

We focused on the most prevalent race/ethnic groups: white (33%), black (44%), and Hispanic (9%). Outcomes included PCa rates, tumor stage, and tumor grade. Percent change was used to describe changes in age-adjusted incidence and mortality rates. Frequency tables and logistic regression models were used to describe trends in proportions of advanced PCa by race and time. Race-by-time interaction terms were retained in the models if statistically significant.

RESULTS

PCa incidence was highest for black men over time. Incidence rates declined over time for all race groups (- 28% for white men to - 38% for Hispanic men). PCa mortality rates declined in a less universal manner (- 5% for blacks to - 32% for whites). Each year, odds increased across all race groups for advanced tumor stage (4% each year among white and Hispanic men and 9% each year among black men) and for advanced tumor grade (4% each year among white and black men and 23% each year among Hispanic men). Among younger men, black men experienced significantly increased odds of advanced tumor stage each year (8%) and Hispanics experienced significantly increased odds of advanced tumor grade each year (30%).

CONCLUSIONS

Black men remain at highest PCa risk relative to other racial/ethnic groups in Philadelphia. Younger black and Hispanic men are at particular risk for advanced PCa at diagnosis.

Consumer credit scores as a novel tool for identifying health in urban U.S. neighborhoods

PURPOSE

Credit scores may operate as a socioeconomic indicator of health: they represent cumulative financial history that directly influences ability to access financial and nonfinancial resources related to health. Yet, little is known about the relationship of credit score and health or to traditional measures of socioeconomic position (SEP). Our objectives were to (1) evaluate the association between area-level credit score and individual self-rated health and (2) compare credit score to traditional markers of area-level SEP in predicting self-rated health.

METHODS

Equifax estimates of average household credit score in 2015 among nine-digit zip code regions were combined with a representative survey of 2083 residents of Philadelphia to estimate the correlation with income, housing value, education, and occupational status and then predict the odds of self-rated health for credit score and each SEP measure.

RESULTS

Credit score was moderately correlated with SEP markers (r = -0.78 to 0.49). After adjusting for area- and individual-level SEP and demographic factors, each SD increase in credit score is associated with 26% greater odds of better self-rated health (odds ratio = 1.26, 95% confidence interval: 1.09-1.46). Credit score had a larger effect size than other SEP markers.

CONCLUSIONS

Credit score may be a useful complement to traditional measures of SEP in assessing health outcomes.

Neighborhood ethnic density and self-rated health: Investigating the mechanisms through social capital and health behaviors

While living with co-ethnics benefits minorities' health, the so-called ethnic density effect, little is known about the mechanisms through which neighborhood ethnic density influences self-rated health. We examine two pathways, namely neighborhood social capital and health behaviors, with a 2010 survey collected in Philadelphia (2297 blacks and 492 Hispanics). The mediation analysis indicates that (1) living with co-ethnics is beneficial to both blacks' and Hispanics' self-rated health, (2) neighborhood social capital and health behaviors mediate almost 15% of the ethnic density effect for blacks, and (3) the two mechanisms do not explain why living with co-ethnics improves Hispanics' health.

The co-occurrence of driver mutations in chronic myeloproliferative neoplasms

Myeloproliferative neoplasms (MPNs) are clonal disorders characterized by proliferation of one or more elements of the myeloid lineage. Key genetic aberrations include the BCR-ABL1 gene rearrangement in Philadelphia chromosome-positive chronic myelogenous leukemia (CML) and JAK2/MPL/CALR aberrations in Philadelphia chromosome-negative MPNs. While thought to be mutually exclusive, occasional isolated reports of coexistence of BCR-ABL1 and JAK2, and JAK2 with MPL or CALR aberrations have been described. Given the paucity of data, clinical characteristics and outcome of patients harboring concurrent Philadelphia-positive and Philadelphia-negative mutations or dual Philadelphia-negative driver mutations have not been systematically evaluated, and their clinical relevance is largely unknown. It is difficult to determine the true relevance of co-existing driver mutations on outcomes given the rarity of its occurrence. In this case series, we describe those patients who had dual driver mutations detected at any point during the course of their disease and characterized their clinical and laboratory features, bone marrow pathology, and overall disease course.

Differential investments and opportunities: How do neighborhood conditions moderate the relationship between perceived housing discrimination and social capital?

Though the adverse consequences of perceived housing discrimination have been documented, little is known about whether such experience undermines one's social capital in a neighborhood and even less is about whether and how this relationship is altered by neighborhood features. We proposed a framework that simultaneously considers within-individual and between-neighborhood processes. We applied multilevel structural equation models to data from Philadelphia (n = 9987) and found that (a) perceived housing discrimination was negatively associated with one's social capital even after other confounders were considered, (b) this negative association could be partly explained by the proliferated daily stress and anxiety mechanisms, (c) differential exposures to neighborhood social disadvantage accounted for the variation in social capital across neighborhoods, and (d) the adverse association between perceived housing discrimination and social capital could be attenuated by neighborhood stability. The findings suggested that appropriate interventions should buffer the negative association of perceived housing discrimination with social capital.

Charles Blagden in revolutionary America: two unpublished letters to John Lloyd

Prior to becoming a secretary of the Royal Society in 1784 Charles Blagden (bapt. 1748-d. 1820) served as a surgeon in the British army during the Revolutionary War in America. In the two unpublished letters of 1778 discussed here, Blagden provides his Welsh friend John Lloyd (1749-1815) with a vivid description of the current state of affairs in America, from a British perspective, and with insights into continuing scientific endeavour in a time of war. The letters illustrate the attempt that two men made to keep alive an intellectual life and are testimony to the rapidity with which matters of scientific interest could be disseminated in the eighteenth century, even during a major international conflict.

The enduring impact of historical and structural racism on urban violence in Philadelphia

Public health approaches to crime and injury prevention are increasingly focused on the physical places and environments where violence is concentrated. In this study, our aim is to explore the association between historic place-based racial discrimination captured in the 1937 Home Owners Loan Corporation (HOLC) map of Philadelphia and present-day violent crime and firearm injuries. The creators of the 1937 HOLC map zoned Philadelphia based in a hierarchical system wherein first-grade and green color zones were used to indicate areas desirable for government-backed mortgage lending and economic development, a second-grade or blue zone for areas that were already developed and stable, a third-grade or yellow zone for areas with evidence of decline and influx of a "low grade population," and fourth-grade or red zone for areas with dilapidated or informal housing and an "undesirable population" of predominately Black residents. We conducted an empirical spatial analysis of the concentration of firearm assaults and violent crimes in 2013 through 2014 relative to zoning in the 1937 HOLC map. After adjusting for socio-demographic factors at the time the map was created from the 1940 Census, firearm injury rates are highest in historically red-zoned areas of Philadelphia. The relationship between HOLC map zones and general violent crime is not supported after adjusting for historical Census data. This analysis extends historic perspective to the relationship between emplaced structural racism and violence, and situates the socio-ecological context in which people live at the forefront of this association.

When Primary Care Providers (PCPs) Help Patients Choose Prostate Cancer Treatment

BACKGROUND

The role of primary care providers (PCPs) in decision making around cancer care remains largely unknown. We evaluated how frequently men with localized prostate cancer report receiving help from their PCP about their treatment, and whether those men who do are less likely to receive definitive treatment.

METHODS

We mailed surveys to men newly diagnosed with localized prostate cancer between 2012 and 2014 in the greater Philadelphia region. Participants were asked whether their PCP helped decide how to treat their cancer. The outcome was receipt of definitive treatment (either radical prostatectomy or radiotherapy).

RESULTS

A total of 2386 men responded (adjusted response rate, 51.1%). Among these men, 38.2% reported receiving help from their PCP regarding choosing a treatment, and 79.6% received definitive treatment. In adjusted analyses, non-Hispanic black men (odds ratio, 1.76; 95% confidence interval, 1.37-2.27) were more likely than non-Hispanic white men to report receiving help from their PCP. However, men who did receive help were not more likely to forgo definitive treatment overall (P = .58) or in the subgroups of men who may be least likely to benefit from definitive treatment.

CONCLUSIONS

Though a substantial proportion of men reported receiving help from their PCP about prostate cancer treatment, these discussions were not associated with different treatment patterns. Further effort is needed to determine how to optimize the role of PCPs in supporting patients to make preference-sensitive cancer decisions.

miR-155 effectively induces apoptosis in K562 Philadelphia positive cell line through upregulation of p27kip1

Introduction: Chronic myelogenous leukemia (CML) is a myeloproliferative disorder caused by the Philadelphia chromosome translocation, at (9; 22), which results in BCR-ABL fusion tyrosine kinase oncoprotein. This fusion induces down-regulation of miR-155. Upregulation of miR-155 can influence cell fate via the effect on p27kip1 and apoptosis. The aim of this study was to induce apoptosis in K562 CML cell line by overexpression of miR-155.

Methods: The K562 cell line was transfected with pLenti-III-pre mir155-GFP constructs through electroporation. Then, overexpression of miR-155 as well as the expression level of p27kip1 and c-Myc was analyzed by quantitative PCR (qPCR). The level of p27 (Kip1) protein expression was measured by Western blot and the Annexin V method was carried out to investigate apoptosis.

Results: Flow cytometric analysis results of K562 cells transfected with pLenti-III-pre mir155-GFP construct showed a significant increase in cell apoptosis. Gene expression and protein level of p27kip1 were upregulated. However, there was no change in c-Myc expression profile.

Conclusion: miR-155 could be a promising approach to aid in the treatment of CML. However, further studies are required in this respect.

Residential segregation and racial disparities in self-rated health: How do dimensions of residential segregation matter?

Previous research on segregation and health has been criticized for overlooking the fact that segregation is a multi-dimensional concept (i.e., evenness, exposure, concentration, centralization, and clustering) and recent evidence drawn from non-black minorities challenges the conventional belief that residential segregation widens racial health disparities. Combining a survey data (n = 18,752) from Philadelphia with the 2010 Census tract (n = 925) data, we examine two theoretical frameworks to understand why the association of segregation with health may differ by race/ethnicity. Specifically, we investigate how each dimension of segregation contributed to racial disparities in self-rated health. We found (1) high levels of white/black concentration could exacerbate the white/black health disparities up to 25 percent, (2) the white/Hispanic health disparities was narrowed by increasing the level of white/Hispanic centralization, and (3) no single dimension of segregation statistically outperforms others. Our findings supported that segregation is bad for blacks but may be beneficial for Hispanics.

Neighborhood Socioeconomic Status and Primary Health Care: Usual Points of Access and Temporal Trends in a Major US Urban Area

Neighborhood socioeconomic status (SES), an overall marker of neighborhood conditions, may determine residents' access to health care, independently of their own individual characteristics. It remains unclear, however, how the distinct settings where individuals seek care vary by neighborhood SES, particularly in US urban areas. With existing literature being relatively old, revealing how these associations might have changed in recent years is also timely in this US health care reform era. Using data on the Philadelphia region from 2002 to 2012, we performed multilevel analysis to examine the associations of neighborhood SES (measured as census tract median household income) with access to usual sources of primary care (physician offices, community health centers, and hospital outpatient clinics). We found no evidence that residence in a low-income (versus high-income) neighborhood was associated with poorer overall access. However, low-income neighborhood residence was associated with less reliance on physician offices [-4.40 percentage points; 95 % confidence intervals (CI) -5.80, -3.00] and greater reliance on the safety net provided by health centers [2.08; 95 % CI 1.42, 2.75] and outpatient clinics [1.61; 95 % CI 0.97, 2.26]. These patterns largely persisted over the 10 years investigated. These findings suggest that safety-net providers have continued to play an important role in ensuring access to primary care in urban, low-income communities, further underscoring the importance of supporting a strong safety net to ensure equitable access to care regardless of place of residence.

The Association of Minority Self-Rated Health with Black versus White Gentrification

There exists controversy as to the impact gentrification of cities has on the well-being of minorities. Some accuse gentrification of causing health disparities for disadvantaged minority populations residing in neighborhoods that are changing as a result of these socioeconomic shifts. Past scholarship has suggested that fears of displacement and social isolation associated with gentrification lead to poorer minority health. However, there is a lack of research that directly links gentrification to minority health outcomes. We address this gap with individual data from the 2008 Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Health Survey and census tract data from the 2000 Decennial Census and the 2006-2010 American Community Survey. We implement logistic multilevel models to determine whether and how a resident's self-rated health is affected by gentrification of their neighborhoods. We find that while gentrification does have a marginal effect improving self-rated health for neighborhood residents overall, it leads to worse health outcomes for Blacks. Accounting for racial change, while gentrification leading to increases in White population has no measurable effect on minority health, "Black gentrification" leads to marginally worse health outcomes for Black respondents. These results demonstrate the limitations that improvements of neighborhood socioeconomic character have in offsetting minority health disparities.

Gentrification and Residential Mobility in Philadelphia

Gentrification has provoked considerable controversy surrounding its effects on residential displacement. Using a unique individual-level, longitudinal data set, this study examines mobility rates and residential destinations of residents in gentrifying neighborhoods during the recent housing boom and bust in Philadelphia for various strata of residents and different types of gentrification. We find that vulnerable residents, those with low credit scores and without mortgages, are generally no more likely to move from gentrifying neighborhoods compared with their counterparts in nongentrifying neighborhoods. When they do move, however, they are more likely to move to lower-income neighborhoods. Residents in gentrifying neighborhoods at the aggregate level have slightly higher mobility rates, but these rates are largely driven by more advantaged residents. These findings shed new light on the heterogeneity in mobility patterns across residents in gentrifying neighborhoods and suggest that researchers should focus more attention on the quality of residential moves and nonmoves for less advantaged residents, rather than mobility rates alone.

High Prevalence of Obesity and High Blood Pressure in Urban Student-Athletes

OBJECTIVES

To assess the prevalence of obesity and hypertension-level blood pressures in an urban, athletic adolescent population using preparticipation physical evaluation (PPE) data.

STUDY DESIGN

The Athlete Health Organization provides free preparticipation physical evaluations to Philadelphia student-athletes via an annual mass-screening event. From 2009 to 2012, Athlete Health Organization personnel performed PPEs on more than 2700 middle school and high school athletes. The PPE included biometric information, a history, and a physical examination. Medical volunteers measured blood pressures using a manual blood pressure cuff with an aneroid manometer. The data from each PPE were collected and analyzed for prevalence of obesity, overweight, and hypertension-level blood pressure readings.

RESULTS

A large percentage of student-athletes were found to be overweight (20%) or obese (24.0%). Many of these athletes also had stage 1 or 2 level blood pressure readings (14.8%), a finding which strongly correlated with elevated body mass index (P < .00001).

CONCLUSIONS

The cardiovascular health of this urban adolescent athletic population is a major concern because their rates of obesity and elevated blood pressure place them at increased risk of cardiovascular complications later in life despite their participation in school athletics.

Reproducible Risk Assessment

Reproducible research is a concept that has emerged in data and computationally intensive sciences in which the code used to conduct all analyses, including generation of publication quality figures, is directly available, and preferably in open source manner. This perspective outlines the processes and attributes, and illustrates the execution of reproducible research via a simple exposure assessment of air pollutants in metropolitan Philadelphia.