201
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He S, Song D, Jian WY. The Association between Urbanization and Depression among the Middle-Aged and Elderly: A Longitudinal Study in China. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2020; 57:46958020965470. [PMID: 33095089 PMCID: PMC7585885 DOI: 10.1177/0046958020965470] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Urbanization has been and will continue to be the mainstream trend of global population movement, including China. Depression is the most common mental disorders and the leading factor of disabilities. However, the impacts of urbanization on the depression occurrence are still unclear. This paper analyzed the data from 3 waves of the China Health and Retirement Longitudinal Study (CHARLS) with sample size as 8510 adults representing the middle aged and elderly group in China. Depression was identified and measured by the 10-item Center for Epidemiological Studies Depression Scale (CESD-10). Urbanization level was measured by population density, GDP per capita and secondary/tertiary industry as percentage to GDP in the China City Statistical Yearbook. The fixed effect regression model was used to explore the association between the changes of urbanization and depression. As result, depression is closely related to the urbanization, protective effects are found for 3 indicators above: The depression prevalence decreases while urbanization level increases (from lowest urbanization level to the highest: P < 0.01). Among the 10 depression symptoms, "Bothered", "Reduced energy leading to diminished activity" and "Hopelessness" are the most significantly improved with urbanization. The impact of urbanization on residents' mental health is a long-term, multi-factor interaction. Therefore we need to fully consider all possible influencing factors, and longer follow-up study to verify.
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Affiliation(s)
- Shan He
- Peking University Health Science Center, Beijing, P.R. China
| | - Duo Song
- Peking University Health Science Center, Beijing, P.R. China
| | - Wei-Yan Jian
- Peking University Health Science Center, Beijing, P.R. China
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202
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Carrere J, Reyes A, Oliveras L, Fernández A, Peralta A, Novoa AM, Pérez K, Borrell C. The effects of cohousing model on people's health and wellbeing: a scoping review. Public Health Rev 2020; 41:22. [PMID: 33042597 PMCID: PMC7539375 DOI: 10.1186/s40985-020-00138-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/25/2020] [Indexed: 11/10/2022] Open
Abstract
Background Housing is a social determinant of health. Extensive research has highlighted its adverse effects on health. However, less is known about the effects of cohousing typology on health, which has the potential to create lively social networks and healthy communities and environments. We report the findings of a scoping study designed to gather and synthesise all known evidence on the relationship between cohousing and wellbeing and health. Method Using the scoping review method, we conducted a literature review in PubMed, ProQuest, Scopus, Web of Science, Science Direct and JSTOR in May 2019 and selected articles published from 1960 onwards, with no geographical limit and no design restrictions. Retrieved articles underwent three sequential screening phases. The results were described through a narrative synthesis of the evidence. Results Of the 2560 articles identified, we selected 25 full-text articles analysing 77 experiences. All of them were conducted in high-income countries. Ten studies analysed the impact of cohousing on physical and mental health or quality of life and wellbeing. Eight of the 10 studies found a positive association. In addition, 22 studies analysed one or more psychosocial determinants of health (such as social support, sense of community and physical, emotional and economic security) and most found a positive association. Through these determinants, quality of life, wellbeing and health could be improved. However, the quality of the evidence was low. Discussion The cohousing model could enhance health and wellbeing mediated by psychosocial determinants of health. However, extreme caution should be exercised in drawing any conclusions due to the dearth of data identified and the designs used in the included studies, with most being cross-sectional or qualitative studies, which precluded causal-based interpretations. Because housing is a major social determinant of health, more evidence is needed on the impact of this model on health through both psychosocial and material pathways.
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Affiliation(s)
- Juli Carrere
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Alexia Reyes
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Laura Oliveras
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain
| | - Anna Fernández
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Andrés Peralta
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain
| | - Ana M Novoa
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona, Pl. Lesseps 1, 08023 Barcelona, Spain.,Institut d'Investigació Biomèdica (IIB Sant Pau), C. Sant Quintí 77, 08041 Barcelona, Spain.,Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Doctor Aiguader 88, 08003 Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos 3-5, Pabellón 11. Planta 0, 28029 Madrid, Spain
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203
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Papadimos TJ, Soghoian SE, Nanayakkara P, Singh S, Miller AC, Saddikuti V, Jayatilleke AU, Dubhashi SP, Firstenberg MS, Dutta V, Chauhan V, Sharma P, Galwankar SC, Garg M, Taylor N, Stawicki SP. COVID-19 Blind Spots: A Consensus Statement on the Importance of Competent Political Leadership and the Need for Public Health Cognizance. J Glob Infect Dis 2020; 12:167-190. [PMID: 33888955 PMCID: PMC8045535 DOI: 10.4103/jgid.jgid_397_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/11/2020] [Accepted: 11/25/2020] [Indexed: 02/07/2023] Open
Abstract
As the COVID-19 pandemic continues, important discoveries and considerations emerge regarding the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pathogen; its biological and epidemiological characteristics; and the corresponding psychological, societal, and public health (PH) impacts. During the past year, the global community underwent a massive transformation, including the implementation of numerous nonpharmacological interventions; critical diversions or modifications across various spheres of our economic and public domains; and a transition from consumption-driven to conservation-based behaviors. Providing essential necessities such as food, water, health care, financial, and other services has become a formidable challenge, with significant threats to the existing supply chains and the shortage or reduction of workforce across many sectors of the global economy. Food and pharmaceutical supply chains constitute uniquely vulnerable and critically important areas that require high levels of safety and compliance. Many regional health-care systems faced at least one wave of overwhelming COVID-19 case surges, and still face the possibility of a new wave of infections on the horizon, potentially in combination with other endemic diseases such as influenza, dengue, tuberculosis, and malaria. In this context, the need for an effective and scientifically informed leadership to sustain and improve global capacity to ensure international health security is starkly apparent. Public health "blind spotting," promulgation of pseudoscience, and academic dishonesty emerged as significant threats to population health and stability during the pandemic. The goal of this consensus statement is to provide a focused summary of such "blind spots" identified during an expert group intense analysis of "missed opportunities" during the initial wave of the pandemic.
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Affiliation(s)
- Thomas J. Papadimos
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Samara E. Soghoian
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Prabath Nanayakkara
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Sarman Singh
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Andrew C. Miller
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | | | | | - Siddharth P. Dubhashi
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Michael S. Firstenberg
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Vibha Dutta
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Vivek Chauhan
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Pushpa Sharma
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Sagar C. Galwankar
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Manish Garg
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Nicholas Taylor
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
| | - Stanislaw P. Stawicki
- On Behalf of the Multidisciplinary ACAIM-WACEM COVID-19 Consensus Group, Bethlehem, PA, USA
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204
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Bucholz EM, Sleeper LA, Goldberg CS, Pasquali SK, Anderson BR, Gaynor JW, Cnota JF, Newburger JW. Socioeconomic Status and Long-term Outcomes in Single Ventricle Heart Disease. Pediatrics 2020; 146:peds.2020-1240. [PMID: 32973120 PMCID: PMC7546087 DOI: 10.1542/peds.2020-1240] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Low socioeconomic status (SES) has emerged as an important risk factor for higher short-term mortality and neurodevelopmental outcomes in children with hypoplastic left heart syndrome and related anomalies; yet little is known about how SES affects these outcomes over the long-term. METHODS We linked data from the Single Ventricle Reconstruction trial to US Census Bureau data to analyze the relationship of neighborhood SES tertiles with mortality and transplantation, neurodevelopment, quality of life, and functional status at 5 and 6 years post-Norwood procedure (N = 525). Cox proportional hazards regression and linear regression were used to assess the association of SES with mortality and neurodevelopmental outcomes, respectively. RESULTS Patients in the lowest SES tertile were more likely to be racial minorities, older at stage 2 and Fontan procedures, and to have more complications and fewer cardiac catheterizations over follow-up (all P < .05) compared with patients in higher SES tertiles. Unadjusted mortality was highest for patients in the lowest SES tertile and lowest in the highest tertile (41% vs 29%, respectively; log-rank P = .027). Adjustment for patient birth and Norwood factors attenuated these differences slightly (P = .055). Patients in the lowest SES tertile reported lower functional status and lower fine motor, problem-solving, adaptive behavior, and communication skills at 6 years (all P < .05). These differences persisted after adjustment for baseline and post-Norwood factors. Quality of life did not differ by SES. CONCLUSIONS Among patients with hypoplastic left heart syndrome, those with low SES have worse neurodevelopmental and functional status outcomes at 6 years. These differences were not explained by other patient or clinical characteristics.
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Affiliation(s)
- Emily M. Bucholz
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts;,Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Lynn A. Sleeper
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts;,Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts
| | - Caren S. Goldberg
- Department of Pediatrics, University of Michigan and C.S. Mott Children’s Hospital, Ann Arbor, Michigan
| | - Sara K. Pasquali
- Department of Pediatrics, University of Michigan and C.S. Mott Children’s Hospital, Ann Arbor, Michigan
| | - Brett R. Anderson
- Division of Pediatric Cardiology, Department of Pediatrics, Columbia University Irving Medical Center and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York City, New York
| | - J. William Gaynor
- Division of Pediatric Cardiac Surgery, Cardiac Center, Children’s Hospital of Pennsylvania, Philadelphia, Pennsylvania; and
| | - James F. Cnota
- Department of Cardiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio
| | - Jane W. Newburger
- Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts;,Department of Pediatrics, Harvard Medical School, Harvard University, Boston, Massachusetts
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205
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Flores MW, Lê Cook B, Mullin B, Halperin-Goldstein G, Nathan A, Tenso K, Schuman-Olivier Z. Associations between neighborhood-level factors and opioid-related mortality: A multi-level analysis using death certificate data. Addiction 2020; 115:1878-1889. [PMID: 32061139 PMCID: PMC7734613 DOI: 10.1111/add.15009] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 08/02/2019] [Accepted: 02/11/2020] [Indexed: 01/08/2023]
Abstract
AIM To identify associations between opioid-related mortality and neighborhood-level risk factors. DESIGN Cross-sectional study. SETTING Massachusetts, USA. PARTICIPANTS Using 2011-14 Massachusetts death certificate data, we identified opioid-related (n = 3089) and non-opioid-related premature deaths (n = 8729). MEASUREMENTS The independent variables consisted of four sets of neighborhood-level factors: (1) psychosocial, (2) economic, (3) built environment and (4) health-related. At the individual level we included the following compositional factors: age at death, sex, race/ethnicity, marital status, education, veteran status and nativity. The primary outcome of interest was opioid-related mortality. FINDINGS Multi-level models identified number of social associations per 10 000 [odds ratio (OR) = 0.84, P = 0.002, 95% confidence interval (CI) = 0.75-0.94] and number of hospital beds per 10 000 (OR = 0.78, P < 0.001, 95% CI = 0.68-0.88) to be inversely associated with opioid-related mortality, whereas the percentage living in poverty (OR = 1.01, P = 0.008, 95% CI = 1.00-1.01), food insecurity rate (OR = 1.21, P = 0.002, 95% CI = 1.07-1.37), number of federally qualified health centers (OR = 1.02, P = 0.028, 95% CI = 1.02-1.08) and per-capita morphine milligram equivalents of hydromorphone (OR = 1.05, P = 0.003, 95% CI = 1.01-1.08) were positively associated with opioid-related mortality. CONCLUSIONS Opioid-related deaths between 2011 and 2014 in the state of Massachusetts appear to be positively associated with the percentage living in poverty, food insecurity rate, number of federally qualified health centers and per-capita morphine milligram equivalents of hydromorphone, but inversely associated with number of social associations per 10 000 and number of hospital beds per 10 000.
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Affiliation(s)
- Michael William Flores
- Health Equity Research Laboratory, Cambridge Health Alliance, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Benjamin Lê Cook
- Health Equity Research Laboratory, Cambridge Health Alliance, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Brian Mullin
- Health Equity Research Laboratory, Cambridge Health Alliance, Cambridge, MA, USA
| | | | - Aparna Nathan
- Department of Bioinformatics, Harvard Medical School, Boston, MA, USA
| | - Kertu Tenso
- Health Equity Research Laboratory, Cambridge Health Alliance, Cambridge, MA, USA
- Boston University School of Public Health, Boston, MA, USA
| | - Zev Schuman-Olivier
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Addiction Services, Cambridge Health Alliance, Cambridge, MA, USA
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206
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Exploring the Impacts of Living in a "Green" City on Individual BMI: A Study of Lingang New Town in Shanghai, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197105. [PMID: 32998282 PMCID: PMC7579353 DOI: 10.3390/ijerph17197105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022]
Abstract
Urban planning and design in the 21st century is increasingly focusing on sustainability, illustrated by the proliferation of greener cities. While operational definitions and the actual planning of these cities can vary considerably (e.g., eco cities and low carbon cities), conceptually, at least, these terms overlap, particularly with regard to how they attempt to achieve both greener infrastructural design and healthier human lifestyles. This paper presents the findings of survey-based research carried out within Lingang New Town in Shanghai in 2019. In the cities of the Global North, the interplay between green infrastructural provision and public health has been of interest, especially in the context of social inequalities; however, there is little research from rapidly urbanizing countries where green urbanism is being increasingly promoted. Using this newly constructed example, we identified a clear positive correlation between moving to a green city and the adoption of healthier lifestyles. The structural equation modelling results suggest that behaviors around the use of green space as well as perceptions of different green space have notable impacts on residents’ physical health, measured by body mass index (BMI). The findings further illustrate systemic inequalities among private housing, rental housing and public housing typologies with regard to the distribution of health benefits.
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207
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Knox BL, Luyet FM, Esernio-Jenssen D. Medical Neglect as a Contributor to Poorly Controlled Asthma in Childhood. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:327-334. [PMID: 33088390 PMCID: PMC7561643 DOI: 10.1007/s40653-019-00290-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Child maltreatment, including medical neglect, is a frequent contributor to the development of asthma as well as a barrier to its proper management. This article aims to review the role of medical neglect as a contributor to poor asthma control. Medical neglect can present as failure of the caretaker to recognize severe asthma symptoms in a child, non-adherence to medical management, failure to prevent chronic exposure to allergens or tobacco smoke, poor child nutrition leading to obesity, and allowing a young child to manage his/her illness without supervision. This article will explore the different factors leading to medical neglect (as illustrated by two cases) and suggest possible interventions aiming to prevent emergency department visits, hospitalizations, and asthma-related deaths.
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Affiliation(s)
- Barbara L. Knox
- University of Wisconsin American Family Children’s Hospital, Madison, WI USA
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
- University of Wisconsin Department of Pediatrics, 600 Highland Avenue, H4-428 CSC, Madison, WI 53792-4108 USA
| | - Francois M. Luyet
- University of Wisconsin American Family Children’s Hospital, Madison, WI USA
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Debra Esernio-Jenssen
- Lehigh Valley Reilly Children’s Hospital, Allentown, PA USA
- Morsani College of Medicine USF Health, Tampa, FL USA
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208
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Affiliation(s)
- Roshanak Mehdipanah
- Roshanak Mehdipanah is an assistant professor in the Department of Health Behavior and Health Education at the University of Michigan School of Public Health, Ann Arbor
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209
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Mancilla VJ, Peeri NC, Silzer T, Basha R, Felini M, Jones HP, Phillips N, Tao MH, Thyagarajan S, Vishwanatha JK. Understanding the Interplay Between Health Disparities and Epigenomics. Front Genet 2020; 11:903. [PMID: 32973872 PMCID: PMC7468461 DOI: 10.3389/fgene.2020.00903] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 07/21/2020] [Indexed: 12/13/2022] Open
Abstract
Social epigenomics has emerged as an integrative field of research focused on identification of socio-environmental factors, their influence on human biology through epigenomic modifications, and how they contribute to current health disparities. Several health disparities studies have been published using genetic-based approaches; however, increasing accessibility and affordability of molecular technologies have allowed for an in-depth investigation of the influence of external factors on epigenetic modifications (e.g., DNA methylation, micro-RNA expression). Currently, research is focused on epigenetic changes in response to environment, as well as targeted epigenetic therapies and environmental/social strategies for potentially minimizing certain health disparities. Here, we will review recent findings in this field pertaining to conditions and diseases over life span encompassing prenatal to adult stages.
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Affiliation(s)
- Viviana J. Mancilla
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Noah C. Peeri
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Talisa Silzer
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Riyaz Basha
- Department of Pediatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Martha Felini
- Department of Pediatrics, Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Harlan P. Jones
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Nicole Phillips
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Meng-Hua Tao
- Department of Biostatistics and Epidemiology, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Srikantha Thyagarajan
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
| | - Jamboor K. Vishwanatha
- Department of Microbiology, Immunology and Genetics, Graduate School of Biomedical Sciences, University of North Texas Health Science Center, Fort Worth, TX, United States
- Texas Center for Health Disparities, University of North Texas Health Science Center, Fort Worth, TX, United States
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210
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Thomson K, Berry R, Robinson T, Brown H, Bambra C, Todd A. An examination of trends in antibiotic prescribing in primary care and the association with area-level deprivation in England. BMC Public Health 2020; 20:1148. [PMID: 32741362 PMCID: PMC7397662 DOI: 10.1186/s12889-020-09227-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 07/08/2020] [Indexed: 11/10/2022] Open
Abstract
Background Internationally, there are growing concerns about antimicrobial resistance. This has resulted in increased scrutiny of antibiotic prescribing trends – particularly in primary care where the majority of prescribing occurs. In England, antibiotic prescribing targets are set nationally but little is known about the local context of antibiotic prescribing. This study aimed to examine trends in antibiotic prescribing (including broad-spectrum), and the association with area-level deprivation and region in England. Methods Antibiotic prescribing data by GP surgery in England were obtained from NHS Business Service Authority for the years 2014–2018. These data were matched with the Index of Multiple Deprivation (IMD) 2015 at the Lower Layer Super Output Area level Lower Layer Super Output Area (LSOA) level. Linear regression methods were employed to explore the relationship between antibiotic use and area-level deprivation as well as region, after controlling for a range of other confounding variables, including health need, rurality, and ethnicity. Results Over time, the amount of antibiotic prescribing significantly reduced from 1.11 items per STAR-PU to 0.96 items per STAR-PU – a reduction of 13.6%. The adjusted models found that, at LSOA level, the most deprived areas of England had the highest levels of antibiotic prescribing (0.03 items per STAR-PU higher). However, broad spectrum antibiotic prescribing exceeding 10% of all antibiotic prescribing within a GP practice was higher in more affluent areas. There were also significant regional differences – with the North East and the East of England having the highest levels of antibiotic prescribing (by 0.16 items per STAR-PU). Conclusion Although antibiotic prescribing has reduced over time, there remains significant variation in by area-level deprivation and region in England – with higher antibiotic prescribing in more deprived areas. Future prescribing targets should account for local factors to ensure the most deprived communities are not inappropriately penalised.
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Affiliation(s)
- Katie Thomson
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Fuse - the UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Rachel Berry
- NHS County Durham Clinical Commissioning Group, Durham, UK
| | - Tomos Robinson
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Heather Brown
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Fuse - the UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Clare Bambra
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Fuse - the UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK
| | - Adam Todd
- Population Heath Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK. .,Fuse - the UKCRC Centre for Translational Research in Public Health, Newcastle upon Tyne, UK. .,School of Pharmacy, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, NE2 4AX, UK.
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211
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Milovanska-Farrington S. Parents labor supply and childhood obesity: Evidence from Scotland. ECONOMICS AND HUMAN BIOLOGY 2020; 38:100897. [PMID: 32599535 DOI: 10.1016/j.ehb.2020.100897] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/25/2020] [Accepted: 06/02/2020] [Indexed: 06/11/2023]
Abstract
More than one third of children worldwide are overweight or obese. This epidemic proportion makes obesity the most common chronic disease among children with short and long-term adverse effects on both affected children and society. This research examines the effect of the extensive and intensive margins of parental employment on children's body mass index (BMI) z-score and likelihood of belonging to different weight status categories in Scotland. We also investigate some mechanisms driving the relationship. The results suggest that there is a positive association between maternal hours worked and child BMI or the probability that a child is overweight or obese. Our analysis of the channels shows that this is attributable to the less time children spend doing physical activity and the more time they watch TV, the more the parents work. The findings are useful for the design of policies whose goal is to improve children's weight outcomes given parental employment.
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Affiliation(s)
- Stefani Milovanska-Farrington
- The University of Tampa, Department of Economics, 401 W Kennedy Blvd, Sykes College of Business, Tampa, FL, 33606, United States.
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Age-Friendly Features in Home and Community and the Self-Reported Health and Functional Limitation of Older Adults: the Role of Supportive Environments. J Urban Health 2020; 97:471-485. [PMID: 32601773 PMCID: PMC7392977 DOI: 10.1007/s11524-020-00462-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
This study aims to identify age-friendly community features that are associated with better health for older adults. This cross-sectional study utilized the 2015 AARP Age-Friendly Communities (AFC) Survey, which includes 66 home and community features that fall within the eight domains specified by the World Health Organization (WHO)'s age-friendly cities guidelines. Two measures of health (self-rated health and functional limitations) were examined using multi-level linear and logistic regressions. Both a greater perceived availability of age-friendly features in communities and a good person-environment fit were associated with better self-rated health and a lower likelihood of reporting functional limitations. The domains of outdoor spaces and buildings, transportation, and social participation and inclusion were consistently associated with these outcomes. Promoting age-friendliness in outdoor spaces and buildings, transportation, and social participation and inclusion domains by providing green spaces, neighborhood safety programs, transportation options, and social opportunities may be the most effective way to support healthy and active aging.
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213
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Laurent AA, Matheson A, Escudero K, Lazaga A. Linking Health and Housing Data to Create a Sustainable Cross-Sector Partnership. Am J Public Health 2020; 110:S222-S224. [PMID: 32663091 DOI: 10.2105/ajph.2020.305693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
In response to the growing regional (and national) focus on health and housing intersections, two public housing authorities (PHAs) in Washington-the King County Housing Authority and the Seattle Housing Authority-joined with Public Health-Seattle & King County to form the Housing and Health (H&H) partnership in 2016. H&H linked Medicaid health claims with PHA administrative data to create a sustainable public-facing dashboard that informs health and housing stakeholders such as an Accountable Community of Health (a governing body that oversees local Medicaid transformation projects), managed care organizations, and PHAs, allowing insights into the low-income communities they serve.
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Affiliation(s)
- Amy A Laurent
- Amy A. Laurent and Alastair Matheson are with the Assessment Policy Development & Evaluation Unit, Public Health-Seattle & King County, Seattle, WA. Katie Escudero is with the King County Housing Authority, Tukwila, WA. Andria Lazaga is with the Seattle Housing Authority
| | - Alastair Matheson
- Amy A. Laurent and Alastair Matheson are with the Assessment Policy Development & Evaluation Unit, Public Health-Seattle & King County, Seattle, WA. Katie Escudero is with the King County Housing Authority, Tukwila, WA. Andria Lazaga is with the Seattle Housing Authority
| | - Katie Escudero
- Amy A. Laurent and Alastair Matheson are with the Assessment Policy Development & Evaluation Unit, Public Health-Seattle & King County, Seattle, WA. Katie Escudero is with the King County Housing Authority, Tukwila, WA. Andria Lazaga is with the Seattle Housing Authority
| | - Andria Lazaga
- Amy A. Laurent and Alastair Matheson are with the Assessment Policy Development & Evaluation Unit, Public Health-Seattle & King County, Seattle, WA. Katie Escudero is with the King County Housing Authority, Tukwila, WA. Andria Lazaga is with the Seattle Housing Authority
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Bush NR, Wakschlag LS, LeWinn KZ, Hertz-Picciotto I, Nozadi SS, Pieper S, Lewis J, Biezonski D, Blair C, Deardorff J, Neiderhiser JM, Leve LD, Elliott AJ, Duarte CS, Lugo-Candelas C, O’Shea TM, Avalos LA, Page GP, Posner J. Family Environment, Neurodevelopmental Risk, and the Environmental Influences on Child Health Outcomes (ECHO) Initiative: Looking Back and Moving Forward. Front Psychiatry 2020; 11:547. [PMID: 32636769 PMCID: PMC7318113 DOI: 10.3389/fpsyt.2020.00547] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 05/27/2020] [Indexed: 12/11/2022] Open
Abstract
The family environment, with all its complexity and diverse components, plays a critical role in shaping neurodevelopmental outcomes in children. Herein we review several domains of the family environment (family socioeconomic status, family composition and home environment, parenting behaviors and interaction styles, parental mental health and functioning, and parental substance use) and discuss how these domains influence neurodevelopment, with particular emphasis on mental health outcomes. We also highlight a new initiative launched by the National Institutes of Health, the Environmental influences on Child Health Outcomes (ECHO) program. We discuss the role that ECHO will play in advancing our understanding of the impact of the family environment on children's risk for psychiatric outcomes. Lastly, we conclude with important unanswered questions and controversies in this area of research, highlighting how ECHO will contribute to resolving these gaps in our understanding, clarifying relationships between the family environment and children's mental health.
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Affiliation(s)
- Nicole R. Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
- Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Lauren S. Wakschlag
- Department of Medical Social Sciences and Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, Il, United States
| | - Kaja Z. LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Irva Hertz-Picciotto
- Department of Public Health Sciences, University of California, Davis, Davis, CA, United States
| | - Sara S. Nozadi
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Sarah Pieper
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Johnnye Lewis
- Community Environmental Health Program, College of Pharmacy, University of New Mexico Health Sciences Center, Albuquerque, NM, United States
| | - Dominik Biezonski
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Clancy Blair
- Department of Population Health, New York University, New York, NY, United States
| | - Julianna Deardorff
- Community Health Sciences, University of California, Berkeley, Berkeley, CA, United States
| | - Jenae M. Neiderhiser
- Department of Psychology, Penn State University, University Park, PA, United States
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, OR, United States
| | - Amy J. Elliott
- Center for Pediatric and Community Research, Avera Research Institute, Sioux Falls, SD, United States
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - Claudia Lugo-Candelas
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Grier P. Page
- Department of Biostatistics and Epidemiology, RTI, Atlanta, GA, United States
| | - Jonathan Posner
- Division of Child and Adolescent Psychiatry, Columbia University, New York, NY, United States
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De Ridder D, Sandoval J, Vuilleumier N, Stringhini S, Spechbach H, Joost S, Kaiser L, Guessous I. Geospatial digital monitoring of COVID-19 cases at high spatiotemporal resolution. Lancet Digit Health 2020; 2:e393-e394. [PMID: 33328043 PMCID: PMC7832151 DOI: 10.1016/s2589-7500(20)30139-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 10/31/2022]
Affiliation(s)
- David De Ridder
- Geneva University Hospitals, 1205 Geneva, Switzerland; Laboratory of Geographic Information Systems, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - José Sandoval
- Geneva University Hospitals, 1205 Geneva, Switzerland
| | | | | | | | - Stéphane Joost
- Geneva University Hospitals, 1205 Geneva, Switzerland; Laboratory of Geographic Information Systems, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | | | - Idris Guessous
- Geneva University Hospitals, 1205 Geneva, Switzerland; Laboratory of Geographic Information Systems, School of Architecture, Civil and Environmental Engineering, École Polytechnique Fédérale de Lausanne, Lausanne, Switzerland.
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Andualem Z, Azene ZN, Azanaw J, Taddese AA, Dagne H. Acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in northwest, Ethiopia. Environ Health Prev Med 2020; 25:20. [PMID: 32539699 PMCID: PMC7296770 DOI: 10.1186/s12199-020-00859-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 06/02/2020] [Indexed: 11/17/2022] Open
Abstract
Background Poor air quality of the household is likely to be the largest public health concern in resource-constrained countries. Exposure to household air pollution, poor working environment, and fuel type used at household level have been associated with respiratory symptoms. This study aimed to assess acute respiratory symptoms and its associated factors among mothers who have under five-years-old children in Gondar city, northwest Ethiopia. Method A cross-sectional study was carried out from February 15, 2019 to June 20, 2019. Study participants were selected using simple random sampling, and data were collected via face-to-face interviews. Binary logistic regression analysis was used to test the association of explanatory and outcome variables. Variables with p < 0.05 were considered as significantly associated with the outcome variable. Results The prevalence of respiratory symptoms among mothers of under-five years-old children in this study was 46.1%. Education (vocational training compared to cannot read and write) (adjusted odd ratio (AOR) = 0.26 at 95% confidence interval (CI): 0.08–0.82), working in dusty environment (AOR = 2.90 at 95% CI: 1.39–6.08), wood fire use (AOR = 0.37 at 95% CI: 0.16–0.85), living in mud- and wood-walled houses (AOR = 0.53 at CI: 0.32–0.89), recent house painting (AOR = 1.95 at 95% CI: 1.03–3.69), new carpet (AOR = 2.02 at 95% CI: 1.08–3.77), pesticide use (AOR = 1.71 at 95% CI: 1.03–2.84), damp stain (AOR = 2.45 at 95% CI: 1.04–5.75), spending longer time in house for 6 to 11 h (AOR = 2.59 at 95% CI: 1.53–4.37) and 11 to 15 h (AOR = 3.47 at 95% CI: 1.87–6.43), and living less than 100 m from unpaved roads/streets (AOR = 4.35 at 95% CI: 2.64–7.18) were significantly associated with respiratory symptoms among mothers of under-five years-old children. Conclusion Respiratory symptoms were common among mothers who have under five-years-old children. Air quality improvement, fuel selection, and residential planning will help to reduce respiratory symptoms.
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Affiliation(s)
- Zewudu Andualem
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Zelalem Nigussie Azene
- Department of Women's and Family Health, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Jember Azanaw
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Asefa Adimasu Taddese
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Henok Dagne
- Department of Environmental and Occupational Health and Safety, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fos EB, Thompson ME, Elnitsky CA, Platonova EA. Community Benefit Spending Among North Carolina's Tax-Exempt Hospitals After Performing Community Health Needs Assessments. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:E1-E8. [PMID: 31136519 DOI: 10.1097/phh.0000000000000921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
CONTEXT As of March 23, 2012, the Internal Revenue Service (IRS) requires tax-exempt hospitals to conduct Community Health Needs Assessment (CHNA) every 3 years to incentivize hospitals to provide programs responsive to the health needs of their communities. OBJECTIVE To examine the distribution and variation in community benefit spending among North Carolina's tax-exempt hospitals 2 years after completing their first IRS-mandated CHNA. DESIGN Cross-sectional study using secondary analysis of published community benefit reports. Community benefit was categorized on the basis of North Carolina Hospital Association's community benefit reporting guidelines. Multiple regression analysis using generalized linear model was used to examine the variation in community benefit spending among study hospitals considering differences in hospital-level and community characteristics. SETTING Fifty-three private, nonprofit hospitals across North Carolina. MAIN OUTCOME MEASURE Dollar expenditures as a percentage of operating expenses of the 2 categories of community benefit spending: patient care financial assistance and community health programs. RESULTS Study hospitals' aggregate community benefit spending was $2.6 billion, 85% of which was in the form of patient care financial assistance, with only 0.7% of total spending allocated to community-building activities such as affordable housing, economic development, and environmental improvements. On average, the study hospitals' community benefit spending was equivalent to 14.6% of operating expenses. Hospitals with 300 or more beds provided significantly higher investments in community health programs as a percentage of their operating expenses than hospitals with 101 to 299 beds (P = .03) or hospitals with 100 or fewer beds (P = .04). Access to care was not associated with patient care financial assistance (P = .81) or community health programs expenditures (P = .94). CONCLUSIONS The study hospitals direct most of their community benefit expenditures to patient care financial assistance (individual welfare) rather than population health improvement initiatives, with virtually no investments in community-building activities that address socioeconomic determinants of health.
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Affiliation(s)
- Elmer B Fos
- Department of Public Health Sciences (Drs Fos, Thompson, and Platonova) and School of Nursing (Dr Elnitsky), University of North Carolina at Charlotte, Charlotte, North Carolina
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218
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VanDerGeest K, Ko LK, Karr C, Torres E, Drury D, Austin E. Private well stewardship within a rural, agricultural Latino community: a qualitative study. BMC Public Health 2020; 20:863. [PMID: 32503551 PMCID: PMC7275588 DOI: 10.1186/s12889-020-08963-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/20/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Nitrate contamination in groundwater disproportionately impacts agricultural Latino communities, creating a significant hazard for Latinos that rely on private wells. Private well users must conduct water testing and other well stewardship behaviors to ensure that their well water is safe to drink. This study sought to identify the key factors impacting private well water testing behavior in rural, agricultural Latino communities. METHODS We conducted 4 focus groups with private well users, 2 in Spanish and 2 in English. We recruited 37 participants from the Lower Yakima Valley, Washington State, a rural, agricultural community with a large Latino population and elevated nitrate concentrations in groundwater. A semi-structured interview guide was developed to capture factors impacting testing as guided by the Risk, Attitudes, Norms, Ability, and Self-Regulation (RANAS) model. Inductive thematic analysis was conducted by two coders to identify common themes. RESULTS Themes emerged around the factors impacting well stewardship, including well water testing, treatment, and maintenance, and were not specific to nitrate contamination. Private well users reported many of the same factors reported in other communities, with the exception of home repair experience and challenges around landlords and neighbors on shared wells, which have not been reported previously. In addition to landlords and neighbors, lack of actionable information, economic limitations, and lack of technical support emerged as factors that made well stewardship burdensome for individuals. The majority of participants reported using bottled water, including many who used point-of-use or point-of-entry water treatment systems. CONCLUSIONS The burden of well stewardship in rural, agricultural Latino communities may suggest the need for interventions at the community, county, or state levels and not at the individual level alone. Additionally, the role of landlords, neighbors on shared wells, and home repair experience in well stewardship represent important areas of exploration for researchers and public health practitioners.
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Affiliation(s)
- Kori VanDerGeest
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA.
| | - Linda K Ko
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
| | - Catherine Karr
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Pacific Northwest Agricultural Safety and Health Center, University of Washington School of Public Health, Seattle, WA, USA
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - Elizabeth Torres
- Northwest Communities Education Center/Radio KDNA, Granger, WA, USA
| | - Dennise Drury
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Pacific Northwest Agricultural Safety and Health Center, University of Washington School of Public Health, Seattle, WA, USA
| | - Elena Austin
- Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, WA, USA
- Pacific Northwest Agricultural Safety and Health Center, University of Washington School of Public Health, Seattle, WA, USA
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Mandel E, E Kendall C, Mason K, Guyton M, Lettner B, Broad J, Altenberg J, Donelle J, Powis J. Impact of comprehensive care on health care use among a cohort of marginalized people living with hepatitis C in Toronto. CANADIAN LIVER JOURNAL 2020. [DOI: 10.3138/canlivj-2019-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: The majority of new hepatitis C (HCV) cases occur among people who inject drugs. In recent years, multidisciplinary models of HCV treatment have emerged that demonstrate successful treatment outcomes for this population, as well as broad positive individual- and system-level impacts. Our objective was to evaluate changes in health care use among a cohort of people living with HCV before and after engagement with one such program. Methods: Program data were uniquely linked to provincial health administrative databases. Rates of emergency department (ED) visits and hospital admissions of clients from 2011 through 2015 ( N = 103) were evaluated using linkages with administrative data for the 2 years before and after program initiation. Data were evaluated using negative binomial regression models with a covariance structure to account for within-individual correlations. Results: Of participants, 72.8% were men (mean age 47 years), and 38% experienced high rates of physical and mental health comorbidity (Aggregated Diagnosis Group score ≥10). Female clients had significantly fewer ED visits 2 years after program initiation (5.04 versus 3.12; risk ratio [RR] 0.61 [95% CI 0.44% to 0.86%]). ED visits for infectious diseases and soft tissue injury were significantly lower for the cohort overall (RRs 0.58 0.51 [95% CIs 0.35% to 0.95% and 0.29% to 0.90%], respectively). Conclusion: Co-locating HCV treatment within comprehensive primary care and harm reduction services appears to have benefits beyond HCV, including a reduction in ED visits among women and a decrease in ED visits for soft tissue infections for all participants.
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Affiliation(s)
- Erin Mandel
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario
| | - Claire E Kendall
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario
- C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario
| | - Kate Mason
- South Riverdale Community Health Centre, Toronto, Ontario
| | | | | | - Jennifer Broad
- South Riverdale Community Health Centre, Toronto, Ontario
| | | | | | - Jeff Powis
- South Riverdale Community Health Centre, Toronto, Ontario
- Michael Garron Hospital, Toronto, Ontario
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220
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Mandel E, E Kendall C, Mason K, Guyton M, Lettner B, Broad J, Altenberg J, Donelle J, Powis J. Impact of comprehensive care on health care use among a cohort of marginalized people living with hepatitis C in Toronto. CANADIAN LIVER JOURNAL 2020; 3:203-211. [DOI: 10.3138/canlivj.2019-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 09/14/2019] [Indexed: 11/20/2022]
Abstract
Background: The majority of new hepatitis C (HCV) cases occur among people who inject drugs. In recent years, multidisciplinary models of HCV treatment have emerged that demonstrate successful treatment outcomes for this population, as well as broad positive individual- and system-level impacts. Our objective was to evaluate changes in health care use among a cohort of people living with HCV before and after engagement with one such program. Methods: Program data were uniquely linked to provincial health administrative databases. Rates of emergency department (ED) visits and hospital admissions of clients from 2011 through 2015 ( N = 103) were evaluated using linkages with administrative data for the 2 years before and after program initiation. Data were evaluated using negative binomial regression models with a covariance structure to account for within-individual correlations. Results: Of participants, 72.8% were men (mean age 47 years), and 38% experienced high rates of physical and mental health comorbidity (Aggregated Diagnosis Group score ≥10). Female clients had significantly fewer ED visits 2 years after program initiation (5.04 versus 3.12; risk ratio [RR] 0.61 [95% CI 0.44% to 0.86%]). ED visits for infectious diseases and soft tissue injury were significantly lower for the cohort overall (RRs 0.58 0.51 [95% CIs 0.35% to 0.95% and 0.29% to 0.90%], respectively). Conclusion: Co-locating HCV treatment within comprehensive primary care and harm reduction services appears to have benefits beyond HCV, including a reduction in ED visits among women and a decrease in ED visits for soft tissue infections for all participants.
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Affiliation(s)
- Erin Mandel
- Toronto Centre for Liver Disease, University Health Network, Toronto, Ontario
| | - Claire E Kendall
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario
- C.T. Lamont Primary Health Care Research Centre, Bruyere Research Institute, Ottawa, Ontario
| | - Kate Mason
- South Riverdale Community Health Centre, Toronto, Ontario
| | | | | | - Jennifer Broad
- South Riverdale Community Health Centre, Toronto, Ontario
| | | | | | - Jeff Powis
- South Riverdale Community Health Centre, Toronto, Ontario
- Michael Garron Hospital, Toronto, Ontario
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["Here (in Sydney) we are lost:" An ethnographic study of life satisfaction among urban aboriginal Australians participating in a community outreach program]. Salud Colect 2020; 16:e2553. [PMID: 32574465 DOI: 10.18294/sc.2020.2553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 04/27/2020] [Indexed: 11/24/2022] Open
Abstract
This ethnographic study was designed to explore living conditions among a group of aboriginal families residing in an urban context, who participated in a recreational social program. The aim of the study was to explore life satisfaction by analyzing their living conditions and cultural capital inscribed in established attitudes, perceptions, and lay knowledge. Fieldwork was carried out in two complementary phases: phase 1, between May 2008 and December 2010, began when the first listed author initiated volunteer work with the organization responsible for the program; in phase 2, which extended from January 2011 to February 2013, participant observation was intensified and semi-structured interviews were carried out. The results indicate that the process of cultural uprooting underscores the experience of social inequality, and suggest a cohort effect that continues to this day. This process of cultural (in)consonance must be taken into account as a key factor when analyzing the living conditions and well-being of ethnic minorities, as well as when developing programs and interventions.
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222
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Ribeiro AI, Barros H. Affordable, Social, and Substandard Housing and Mortality: The EPIPorto Cohort Study, 1999-2019. Am J Public Health 2020; 110:1060-1067. [PMID: 32437286 DOI: 10.2105/ajph.2020.305661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To examine the association between residence in different housing typologies and all-cause and cause-specific mortality, and to compare with the 25 × 25 risk factors defined by the World Health Organization.Methods. We used data from EPIPorto cohort (Porto, Portugal; n = 2485). We georeferenced and matched participants to a housing type-conventional, affordable, social, or substandard housing (locally called ilhas). We used Poisson regression models to estimate mortality rates and associations.Results. Age- and sex-adjusted mortality rates (per 100 000 person-years) were 713 (95% confidence interval [CI] = 584, 863) for individuals residing in conventional housing, and 1019 (95% CI = 637, 1551), 1200 (95% CI = 916, 1551), and 1239 (95% CI = 839, 1772) for individuals residing in affordable housing, social housing, and ilhas, respectively. After further adjustment, the associations between mortality and residence in social housing (rate ratio [RR] = 1.59; 95% CI = 1.22, 2.06) and in ilhas (RR = 1.64; 95% CI = 1.12, 2.33) remained. The association between disadvantaged housing and mortality was stronger than that observed for well-established risk factors such as hypertension, sedentariness, heavy drinking, manual occupation, or obesity.Conclusions. Disadvantaged housing is a major risk factor for mortality that should be accounted for by health policies and surveillance systems.
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Affiliation(s)
- Ana Isabel Ribeiro
- The authors are with EPIUnit-Instituto de Saúde Pública and Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
| | - Henrique Barros
- The authors are with EPIUnit-Instituto de Saúde Pública and Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
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Pneumonia among Under-Five Children in Northwest Ethiopia: Prevalence and Predictors-A Community-Based Cross-Sectional Study. Int J Pediatr 2020; 2020:3464907. [PMID: 32411257 PMCID: PMC7211243 DOI: 10.1155/2020/3464907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/23/2020] [Accepted: 04/24/2020] [Indexed: 11/18/2022] Open
Abstract
Background Acute respiratory infections in particular pneumonia constitutes the leading cause of morbidity and mortality among children under five years of age throughout the world. In Ethiopia, pneumonia continues to be the major childhood problem and killer, particularly in the study area. However, evidence dealing with the problem is still unavailable. The current study is aimed at determining the magnitude and risk factors of childhood pneumonia in Gondar City. Methods A community-based cross-sectional study was employed in five randomly selected clusters/subcities of Gondar City. A total of 792 child-mother/caregiver pairs in the selected subcities/clusters were included. A pretested and validated questionnaire was used by trained supervisors through house-to-house visits to collect the data. Binary logistic regression (bivariable and multivariable) was employed. An adjusted odds ratio with 95% confidence interval was used to declare statistically significant variables on the basis of p < 0.05 in the multivariable logistic regression model. Results The prevalence of pneumonia among under-five children in the current study was found to be 12% with 95% CI: 10% to 14.4%. The presence of unpaved road within 100 m of the house (AOR = 2.27, 95% CI: 1.41-3.66), living within 100 m of heavy traffic (AOR = 1.94, 95% CI: 1.19-3.16), the habit of not opening doors while cooking (AOR = 1.62, 95% CI: 1.01-2.62), the presence of cockroach infestation (AOR = 1.98, 95% CI: 1.25-3.14), and new carpet in the house (AOR = 1.75, 95% CI: 1.01-3.03) were statistically significant variables associated with childhood pneumonia. Conclusions This study indicated that the prevalence of childhood pneumonia is still high. As such, enhancing strategies that would address unpaved roads within 100 m of the house, living within 100 m of heavy traffic, the habit of not opening doors while cooking, cockroach infestation, and new carpet in the house to reduce the burden of childhood pneumonia needs to be advocated.
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Boyraz G, Legros DN. Coronavirus Disease (COVID-19) and Traumatic Stress: Probable Risk Factors and Correlates of Posttraumatic Stress Disorder. JOURNAL OF LOSS & TRAUMA 2020. [DOI: 10.1080/15325024.2020.1763556] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Güler Boyraz
- Department of Psychology, Pace University, New York, New York, USA
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225
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Assessment of Child Lead Exposure in a Philadelphia Community, 2014. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2020; 25:53-61. [PMID: 29324565 DOI: 10.1097/phh.0000000000000711] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Several urban neighborhoods in Philadelphia, Pennsylvania, have a history of soil, household lead paint, and potential lead-emitting industry contamination. OBJECTIVES To (1) describe blood lead levels (BLLs) in target neighborhoods, (2) identify risk factors and sources of lead exposure, (3) describe household environmental lead levels, and (4) compare results with existing data. METHODS A simple, random, cross-sectional sampling strategy was used to enroll children 8 years or younger living in selected Philadelphia neighborhoods with a history of lead-emitting industry during July 2014. Geometric mean of child BLLs and prevalence of BLLs of 5 μg/dL or more were calculated. Linear and logistic regression analyses were used to ascertain risk factors for elevated BLLs. RESULTS Among 104 children tested for blood lead, 13 (12.4%; 95% confidence interval [CI], 7.5-20.2) had BLLs of 5 μg/dL or more. The geometric mean BLL was 2.0 μg/dL (95% CI, 1.7-2.3 μg/dL). Higher geometric mean BLLs were significantly associated with front door entryway dust lead content, residence built prior to 1900, and a child currently or ever receiving Medicaid. Seventy-one percent of households exceeded the screening level for soil, 25% had an elevated front door floor dust lead level, 28% had an elevated child play area floor dust lead level, and 14% had an elevated interior window dust lead level. Children in households with 2 to 3 elevated environmental lead samples were more likely to have BLLs of 5 μg/dL or more. A spatial relationship between household proximity to historic lead-emitting facilities and child BLL was not identified. CONCLUSION Entryway floor dust lead levels were strongly associated with blood lead levels in participants. Results underscore the importance to make housing lead safe by addressing all lead hazards in and around the home. Reduction of child lead exposure is crucial, and continued blood lead surveillance, testing, and inspection of homes of children with BLLs of 5 μg/dL or more to identify and control lead sources are recommended. Pediatric health care providers can be especially vigilant screening Medicaid-eligible/enrolled children and children living in very old housing.
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226
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Kennedy K, Allenbrand R, Bowles E. The Role of Home Environments in Allergic Disease. Clin Rev Allergy Immunol 2020; 57:364-390. [PMID: 30684120 DOI: 10.1007/s12016-018-8724-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Allergic diseases are surprisingly common, chronic health conditions. The primary location where the vast majority of people are exposed to allergens and other substances is in their home. This means it is important to understand home environments and how a home's systems function and interact-and that how we occupy these spaces plays a crucial role in both environmental exposure and management of allergic disease. This review provides an overview of what is understood about home environmental exposure and its impact on our health, and proposes a systematic process for using a patient's environmental history to develop individualized, manageable and cost-effective recommendations. Once occupant-related information has been gathered, a home environmental exposure assessment should be performed focused on identifying the relationships between any identified sources of contaminants and the housing systems, and conditions that may be contributing to exposure. The results and recommendations from this assessment can then be used to guide exposure-reduction efforts by patients and/or their caregivers in an effort to improve disease management. In this review, we'll discuss three different types of home interventions-active, which must be routinely performed by the patient and/or caregiver, passive, which are interventions that work without routine, direct interaction from the homeowner, and behavioral changes in how the home environment is cleaned and maintained for long-term reduction of allergens. In this review, and others evaluated for this discussion, a significant number of home environmental assessment and intervention programs were shown to be cost effective, with the majority of programs showing a net positive return on investment. It is important to recognize that to be cost effective, the level and intensity of services offered through home visit programs need be stratified, based on the estimated health risks of the patient, in order to tailor the assessment and target the interventions to a patient's needs while maximizing cost effectiveness.
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Affiliation(s)
- Kevin Kennedy
- Section of Toxicology and Environmental Health, Children's Mercy Kansas City, Kansas City, USA.
| | - Ryan Allenbrand
- Section of Toxicology and Environmental Health, Children's Mercy Kansas City, Kansas City, USA
| | - Eric Bowles
- Section of Toxicology and Environmental Health, Children's Mercy Kansas City, Kansas City, USA
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227
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Hazekamp C, Yousuf S, Day K, Daly MK, Sheehan K. Eviction and Pediatric Health Outcomes in Chicago. J Community Health 2020; 45:891-899. [DOI: 10.1007/s10900-020-00806-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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228
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Boch SJ, Taylor DM, Danielson ML, Chisolm DJ, Kelleher KJ. 'Home is where the health is': Housing quality and adult health outcomes in the Survey of Income and Program Participation. Prev Med 2020; 132:105990. [PMID: 31954138 PMCID: PMC7024670 DOI: 10.1016/j.ypmed.2020.105990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 12/13/2019] [Accepted: 01/12/2020] [Indexed: 11/22/2022]
Abstract
Nearly a quarter of the homes in the United States were considered unhealthy or inadequate, but whether these housing characteristics have direct effects on health or whether they are driven by other contextual housing and neighborhood characteristics remains unclear. The purpose of this study was to quantify the independent associations between poor housing quality and adult health outcomes, adjusting for socioeconomic factors (e.g. income to poverty ratio, food insecurity) and other contextual housing characteristics (e.g. rental status, number of people per household, unsafe neighborhood). Using in-person household interview data from wave 1 of the 2014 Survey of Income and Program Participation (SIPP), a secondary analysis was performed using a series of logistic regression models. The 2014 SIPP sample is a multistage stratified sample of 53,070 housing units designed to represent the civilian, noninstitutionalized population of the United States (N = 55,281 adults ages 18 and older). Our results indicate that each additional poor housing characteristic was associated with poorer health status (OR: 1.17, CI [1.11, 1.23]), higher medical utilization (OR: 1.11 CI: [1.06, 1.16]), and a higher likelihood of hospitalization (OR: 1.07, CI [1.02, 1.12]). Non-housing-related government assistance, food security, and safe neighborhoods only partially explained associations between housing quality and health outcomes. Evaluating current local, state, and federal policy on housing quality standards may help determine if these standards decrease the number of Americans residing in inadequate homes or result in improvements in health and reductions in healthcare costs. Simply put, the home is where [we suggest] the health is.
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Affiliation(s)
- Samantha J Boch
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA; Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
| | - Danielle M Taylor
- Health and Disability Statistics Branch, U.S. Census Bureau, Suitland, MD, USA
| | - Melissa L Danielson
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Deena J Chisolm
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA; Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Kelly J Kelleher
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA; Abigail Wexner Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
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229
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Mosen DM, Banegas MP, Benuzillo JG, Hu WR, Brooks NB, Ertz-Berger BL. Association Between Social and Economic Needs With Future Healthcare Utilization. Am J Prev Med 2020; 58:457-460. [PMID: 31831290 DOI: 10.1016/j.amepre.2019.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/03/2019] [Accepted: 10/04/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Unmet social and economic needs are associated with poor health outcomes, but little is known about how these needs are predictive of future healthcare utilization. This study examined the association of social and economic needs identified during medical visits with future hospitalizations and emergency department visits. METHODS Individuals with electronic health record-coded social and economic needs during a primary care, emergency department, or urgent care visit at Kaiser Permanente Northwest from October 1, 2016 to November 31, 2017 (case patients) were identified, as well as individuals who had visits during that time period but had no electronic health record-coded needs (control patients). The 2 groups were compared on sociodemographic characteristics, comorbidities, and healthcare utilization in the prior year. Finally, logistic regression assessed the relationship between documented needs and hospitalizations and emergency department visits in the 12 months following the index visit, controlling for sociodemographic characteristics, comorbidities, and prior healthcare utilization. Statistical analysis was completed in April 2019. RESULTS Case patients differed significantly from control patients on sociodemographic characteristics and had higher rates of comorbidities and prior healthcare utilization. Social and economic needs documented during the index visit were associated with significantly higher rates of hospitalization and emergency department visits in the 12 months following the visit, controlling for sociodemographic characteristics, comorbidities, and prior utilization. CONCLUSIONS These results demonstrate that documented social and economic needs are a powerful predictor of future hospitalization and emergency department use and suggest the need for research into whether interventions to address these needs can influence healthcare utilization.
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Affiliation(s)
- David M Mosen
- Kaiser Permanente Center for Health Research, Portland, Oregon.
| | | | | | - Weiming R Hu
- Kaiser Permanente Center for Health Research, Portland, Oregon
| | - Neon B Brooks
- Kaiser Permanente Center for Health Research, Portland, Oregon
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230
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Tusting LS, Gething PW, Gibson HS, Greenwood B, Knudsen J, Lindsay SW, Bhatt S. Housing and child health in sub-Saharan Africa: A cross-sectional analysis. PLoS Med 2020; 17:e1003055. [PMID: 32203504 PMCID: PMC7089421 DOI: 10.1371/journal.pmed.1003055] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Accepted: 02/19/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Housing is essential to human well-being but neglected in global health. Today, housing in Africa is rapidly improving alongside economic development, creating an urgent need to understand how these changes can benefit health. We hypothesised that improved housing is associated with better health in children living in sub-Saharan Africa (SSA). We conducted a cross-sectional analysis of housing conditions relative to a range of child health outcomes in SSA. METHODS AND FINDINGS Cross-sectional data were analysed for 824,694 children surveyed in 54 Demographic and Health Surveys, 21 Malaria Indicator Surveys, and two AIDS Indicator Surveys conducted in 33 countries between 2001 and 2017 that measured malaria infection by microscopy or rapid diagnostic test (RDT), diarrhoea, acute respiratory infections (ARIs), stunting, wasting, underweight, or anaemia in children aged 0-5 years. The mean age of children was 2.5 years, and 49.7% were female. Housing was categorised into a binary variable based on a United Nations definition comparing improved housing (with improved drinking water, improved sanitation, sufficient living area, and finished building materials) versus unimproved housing (all other houses). Associations between house type and child health outcomes were determined using conditional logistic regression within surveys, adjusting for prespecified covariables including age, sex, household wealth, insecticide-treated bed net use, and vaccination status. Individual survey odds ratios (ORs) were pooled using random-effects meta-analysis. Across surveys, improved housing was associated with 8%-18% lower odds of all outcomes except ARI (malaria infection by microscopy: adjusted OR [aOR] 0.88, 95% confidence intervals [CIs] 0.80-0.97, p = 0.01; malaria infection by RDT: aOR 0.82, 95% CI 0.77-0.88, p < 0.001; diarrhoea: aOR 0.92, 95% CI 0.88-0.97, p = 0.001; ARI: aOR 0.96, 95% CI 0.87-1.07, p = 0.49; stunting: aOR 0.83, 95% CI 0.77-0.88, p < 0.001; wasting: aOR 0.90, 95% CI 0.83-0.99, p = 0.03; underweight: aOR 0.85, 95% CI 0.80-0.90, p < 0.001; any anaemia: aOR 0.87, 95% CI 0.82-0.92, p < 0.001; severe anaemia: aOR 0.89, 95% CI 0.84-0.95, p < 0.001). In comparison, insecticide-treated net use was associated with 16%-17% lower odds of malaria infection (microscopy: aOR 0.83, 95% CI 0.78-0.88, p < 0.001; RDT: aOR 0.84, 95% CI 0.79-0.88, p < 0.001). Drinking water source and sanitation facility alone were not associated with diarrhoea. The main study limitations are the use of self-reported diarrhoea and ARI, as well as potential residual confounding by socioeconomic position, despite adjustments for household wealth and education. CONCLUSIONS In this study, we observed that poor housing, which includes inadequate drinking water and sanitation facility, is associated with health outcomes known to increase child mortality in SSA. Improvements to housing may be protective against a number of important childhood infectious diseases as well as poor growth outcomes, with major potential to improve children's health and survival across SSA.
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Affiliation(s)
- Lucy S. Tusting
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Peter W. Gething
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Harry S. Gibson
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, United Kingdom
| | - Brian Greenwood
- Department of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Jakob Knudsen
- The Royal Danish Academy of Fine Arts, Schools of Architecture, Design and Conservation, Copenhagen, Denmark
| | - Steve W. Lindsay
- Department of Biosciences, Durham University, Durham, United Kingdom
| | - Samir Bhatt
- Big Data Institute, Nuffield Department of Medicine, University of Oxford, United Kingdom
- Department of Infectious Disease Epidemiology, Imperial College London, London, United Kingdom
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Harrington RA, Califf RM, Balamurugan A, Brown N, Benjamin RM, Braund WE, Hipp J, Konig M, Sanchez E, Joynt Maddox KE. Call to Action: Rural Health: A Presidential Advisory From the American Heart Association and American Stroke Association. Circulation 2020; 141:e615-e644. [PMID: 32078375 DOI: 10.1161/cir.0000000000000753] [Citation(s) in RCA: 151] [Impact Index Per Article: 37.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Understanding and addressing the unique health needs of people residing in rural America is critical to the American Heart Association's pursuit of a world with longer, healthier lives. Improving the health of rural populations is consistent with the American Heart Association's commitment to health equity and its focus on social determinants of health to reduce and ideally to eliminate health disparities. This presidential advisory serves as a call to action for the American Heart Association and other stakeholders to make rural populations a priority in programming, research, and policy. This advisory first summarizes existing data on rural populations, communities, and health outcomes; explores 3 major groups of factors underlying urban-rural disparities in health outcomes, including individual factors, social determinants of health, and health delivery system factors; and then proposes a set of solutions spanning health system innovation, policy, and research aimed at improving rural health.
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232
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Williams AA, Allen JG, Catalano PJ, Spengler JD. The Role of Individual and Small-Area Social and Environmental Factors on Heat Vulnerability to Mortality Within and Outside of the Home in Boston, MA. CLIMATE 2020; 8. [PMID: 35368800 PMCID: PMC8974638 DOI: 10.3390/cli8020029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Climate change is resulting in heatwaves that are more frequent, severe, and longer lasting, which is projected to double-to-triple the heat-related mortality in Boston, MA if adequate climate change mitigation and adaptation strategies are not implemented. A case-only analysis was used to examine subject and small-area neighborhood characteristics that modified the association between hot days and mortality. Deaths of Boston, Massachusetts residents that occurred from 2000–2015 were analyzed in relation to the daily temperature and heat index during the warm season as part of the case-only analysis. The modification by small-area (census tract, CT) social, and environmental (natural and built) factors was assessed. At-home mortality on hot days was driven by both social and environmental factors, differentially across the City of Boston census tracts, with a greater proportion of low-to-no income individuals or those with limited English proficiency being more highly represented among those who died during the study period; but small-area built environment features, like street trees and enhanced energy efficiency, were able to reduce the relative odds of death within and outside the home. At temperatures below current local thresholds used for heat warnings and advisories, there was increased relative odds of death from substance abuse and assault-related altercations. Geographic weighted regression analyses were used to examine these relationships spatially within a subset of at-home deaths with high-resolution temperature and humidity data. This revealed spatially heterogeneous associations between at-home mortality and social and environmental vulnerability factors.
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Affiliation(s)
- Augusta A. Williams
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Correspondence:
| | - Joseph G. Allen
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Paul J. Catalano
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Data Sciences, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - John D. Spengler
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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233
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Reap M, Pornwattanavate S, Thame C, Van der Putten M. The social determinants of health of the Urak Lawoi' of southern Thailand. BMC Public Health 2020; 20:197. [PMID: 32028923 PMCID: PMC7006382 DOI: 10.1186/s12889-020-8283-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Accepted: 01/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Traditionally, most Western models of health viewed sickness and disease as a product of individual factors such as personal behaviors and genetic predisposition; consequently, healthcare interventions were largely focused on fixing the individual, with little attention placed on contributing external factors. The WHO's "Social Determinants of Health" (SDH) framework, however, takes a broader ecological perspective that suggests that interventions must occur at multiple levels in order for good health to be achieved on an equitable basis. This model views health as a function of many circumstantial and environmental factors that are continuously and simultaneously interacting across multiple domains. These factors include structural mechanisms, such as laws and policies; socio-economic conditions, such as education and occupation; and intermediary circumstances, such as living and working conditions. Utilizing the SDH framework as a guide, this qualitative study sought to identify which specific determinants are most significant and present the greatest risk to the health and well-being of the Urak Lawoi' (UL), a "sea nomad" group indigenous to southern Thailand. METHODS Interviews, household surveys, and focus group discussions were utilized to gather primary data from 71 subjects in three different UL communities in southern Thailand. In addition, a comprehensive literature review of relevant international mechanisms, national laws, and national policies was conducted. All data collected was analyzed and coded utilizing HyperRESEARCH. RESULTS In all three communities, education and livelihoods were found to be the most critical determinants. Additionally, land grabbing and living conditions were identified as dire issues on Ko Lipe. The law and policy review revealed several deviations between international mechanisms and national laws and policies in both enshrinement and enforcement, with the Royal Thai Government (RTG) often overlooking the interests of the UL when formulating laws and policies. CONCLUSIONS The above-mentioned determinants, along other structural and intermediary determinants, are synergizing, thereby placing the UL at increased risk of poorer health and health outcomes compared to other Thais living in the same vicinities. To rectify this, the RTG must reform national laws and policies that harm the UL, and civil society must hold them accountable. Several recommendations are offered to achieve a better future for the Urak Lawoi'.
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Affiliation(s)
- Maura Reap
- School of Global Studies, Thammasat University, Rangsit, Thailand
| | | | - Charlie Thame
- Faculty of Political Science, Thammasat University, Bangkok, Thailand
| | - Marc Van der Putten
- Center of Excellence in Global Health, Faculty of Public Health, Thammasat University, Rangsit, Thailand
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234
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Home visits for pediatric asthma - A strategy for comprehensive asthma management through prevention and reduction of environmental asthma triggers in the home. Curr Probl Pediatr Adolesc Health Care 2020; 50:100753. [PMID: 32144077 DOI: 10.1016/j.cppeds.2020.100753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Families often struggle to manage their child's asthma. Clinicians caring for children with asthma struggle too as they are tasked with balancing the limited time available in clinic and the need to provide comprehensive care. As a direct consequence, critical gaps in asthma care remain with respect to asthma education and the identification and reduction of environmental asthma triggers in the home. A home visit model that augments clinic-based care is a viable way to fill gaps in understanding, address incomplete adherence patterns, improve disease control by shifting the focus of asthma management to reduction of environmental asthma triggers, and bring cost savings to the health care system.
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235
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Thompson JS, Huxley JN, Hudson CD, Kaler J, Gibbons J, Green MJ. Field survey to evaluate space allowances for dairy cows in Great Britain. J Dairy Sci 2020; 103:3745-3759. [PMID: 32008789 DOI: 10.3168/jds.2019-17004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 11/15/2019] [Indexed: 01/19/2023]
Abstract
Housing conditions can affect health of cows by increasing exposure to biological, chemical, and physical hazards, resulting in increased disease. A report in 2014 indicated that 99% of UK dairy cows are housed during winter months and that an increasing number of farms are committing to year-round indoor-housing management systems. Current literature does not provide a clear understanding of the relationship between cow health, welfare, and production, and the housing environment. Loafing space, in this case defined as non-feed, non-lying, and non-high traffic areas of the housed environment, is considered an important component of housing for dairy cows; however, the scientific literature associated with this subject is sparse internationally. The aim of this research was to explore current housing of dairy cows across Great Britain, with specific focus on understanding the practices and variability associated with space allowance. A secondary aim was to explore farmer opinions and knowledge on the value of living space. A single researcher visited 53 randomly selected farms, from a representative sample group, once during the winter housing period 2017-18. Data collection consisted of 3 elements: collation of basic farm details, precise measurement of adult dairy cow accommodation, and a questionnaire to capture farmer opinions on space allowances. Statistical analysis was undertaken to assess variation among farms in total space, loafing space, and living space per cow. A new metric, termed "living space," was defined to describe the additional space availability for dairy cows above that deemed to be a baseline requirement. Large variability was identified between farms in total space available per cow, with a range from 5.4 to 12.7 m2 [mean = 8.3 m2, median = 8.2 m2, interquartile range (IQR) = 1.9 m2]. The mean living space was 2.5 m2, with a range of 0.5 m2 to 6.4 m2 (median = 2.4 m2, IQR = 1.6 to 3.2 m2). Responses from a farmer questionnaire on importance of loafing space revealed that farmers felt it was essential for cow welfare, over half of farmers scoring this ≥8 on a 0 to 10 scale. Farmers were categorized into 4 latent classes based on their attitudes toward the importance of loafing space. In a linear model to predict the "living space" provided on each farm, geographical location and latent class of farmer attitude were covariates significantly associated with the amount of space provided. This study is the first worldwide to quantify variability in loafing and living spaces for dairy herds; further research is required to evaluate the extent to which variation in quantity and quality of space influences cow health, welfare, and productivity, as well as farm economics and emissions.
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Affiliation(s)
- J S Thompson
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
| | - J N Huxley
- School of Veterinary Science, Massey University, Palmerston North, 4474, New Zealand
| | - C D Hudson
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
| | - J Kaler
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom
| | - J Gibbons
- Agriculture and Horticulture Development Board (AHDB), Stoneleigh, Kenilworth, CV8 2TL, United Kingdom
| | - M J Green
- School of Veterinary Medicine and Science, University of Nottingham, Sutton Bonington Campus, Leicestershire, LE12 5RD, United Kingdom.
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236
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Semenza DC, Isom Scott DA, Grosholz JM, Jackson DB. Disentangling the health-crime relationship among adults: The role of healthcare access and health behaviors. Soc Sci Med 2020; 247:112800. [PMID: 32006755 DOI: 10.1016/j.socscimed.2020.112800] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 11/19/2019] [Accepted: 01/11/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Daniel C Semenza
- Department of Sociology, Anthropology, and Criminal Justice, Rutgers University, Camden, USA.
| | - Deena A Isom Scott
- Department of Criminology and Criminal Justice and African American Studies Program, University of South Carolina, USA
| | - Jessica M Grosholz
- Department of Liberal Arts and Social Sciences, University of South Florida, Sarasota-Manatee, USA
| | - Dylan B Jackson
- Department of Criminal Justice, University of Texas, San Antonio, USA
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237
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Zayed L, Chebli P, Shalabi I, Taha N, Abboud S. Health Assessment of the Arab American Community in Southwest Chicago. J Community Health 2020; 45:761-767. [PMID: 31916178 DOI: 10.1007/s10900-020-00791-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Chicago is among the top five metropolitan areas in the United States where Arab Americans reside; however, we have little available data on their perceptions of personal or community health. We collected 200 community health surveys in collaboration with a community-based organization that serves mainly Arabs in Chicago's southwest suburbs. The survey evaluated perceived community and personal health. In a mostly female, married, and low-income sample, participants identified cancers, diabetes, and high blood pressure/cholesterol as the top three health problems, while alcohol abuse, drug abuse, and overweight/obesity as the top three risky behaviors within the community. Gender differences, age differences, and educational level differences were found on certain determinants of health regarding the health of the community, perceived health problems, and risky behaviors. Our data validates previous findings from the literature highlighting cancer, diabetes, and high blood pressure as health priorities among Arabs, but offers new insights into unidentified issues within the Arab American community in Southwest Chicago such as alcohol, drug abuse, and child neglect/abuse. Furthermore, our findings warrant the need for classifying Arabs as a separate minority population facing health disparities.
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Affiliation(s)
- Linda Zayed
- Community Health Worker, Alliance Chicago, Chicago, IL, USA
| | - Perla Chebli
- Community Health Sciences Division, School of Public Health, University of Illinois At Chicago, Chicago, IL, USA
| | | | | | - Sarah Abboud
- Department of Women, Children, and Family Health Science, College of Nursing, University of Illinois At Chicago, 845 S. Damen Avenue, Chicago, IL, 60612, USA.
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238
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Kolak M, Bhatt J, Park YH, Padrón NA, Molefe A. Quantification of Neighborhood-Level Social Determinants of Health in the Continental United States. JAMA Netw Open 2020; 3:e1919928. [PMID: 31995211 PMCID: PMC6991288 DOI: 10.1001/jamanetworkopen.2019.19928] [Citation(s) in RCA: 110] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
IMPORTANCE An association between social and neighborhood characteristics and health outcomes has been reported but remains poorly understood owing to complex multidimensional factors that vary across geographic space. OBJECTIVES To quantify social determinants of health (SDOH) as multiple dimensions across the continental United States (the 48 contiguous states and the District of Columbia) at a small-area resolution and to examine the association of SDOH with premature mortality within Chicago, Illinois. DESIGN, SETTING, AND PARTICIPANTS In this cross-sectional study, census tracts from the US Census Bureau from 2014 were used to develop multidimensional SDOH indices and a regional typology of the continental United States at a small-area level (n = 71 901 census tracts with approximately 312 million persons) using dimension reduction and clustering machine learning techniques (unsupervised algorithms used to reduce dimensions of multivariate data). The SDOH indices were used to estimate age-adjusted mortality rates in Chicago (n = 789 census tracts with approximately 7.5 million persons) with a spatial regression for the same period, while controlling for violent crime. MAIN OUTCOMES AND MEASURES Fifteen variables, measured as a 5-year mean, were selected to characterize SDOH as small-area variations for demographic characteristics of vulnerable groups, economic status, social and neighborhood characteristics, and housing and transportation availability at the census-tract level. This SDOH data matrix was reduced to 4 indices reflecting advantage, isolation, opportunity, and mixed immigrant cohesion and accessibility, which were then clustered into 7 distinct multidimensional neighborhood typologies. The association between SDOH indices and premature mortality (defined as death before age 75 years) in Chicago was measured by years of potential life lost and aggregated to a 5-year mean. Data analyses were conducted between July 1, 2018, and August 30, 2019. RESULTS Among the 71 901 census tracts examined across the continental United States, a median (interquartile range) of 27.2% (47.1%) of residents had minority status, 12.1% (7.5%) had disabilities, 22.9% (7.6%) were 18 years and younger, and 13.6% (8.1%) were 65 years and older. Among the 789 census tracts examined in Chicago, a median (interquartile range) of 80.4% (56.3%) of residents had minority status, 10.2% (8.2%) had disabilities, 23.2% (10.9%) were 18 years and younger, and 9.5% (7.1%) were 65 years and older. Four SDOH indices accounted for 71% of the variance across all census tracts in the continental United States in 2014. The SDOH neighborhood typology of extreme poverty, which is of greatest concern to health care practitioners and policy advocates, comprised only 9.6% of all census tracts across the continental United States but characterized small areas of known public health crises. An association was observed between all SDOH indices and age-adjusted premature mortality rates in Chicago (R2 = 0.63; P < .001), even after accounting for violent crime and spatial structures. CONCLUSIONS AND RELEVANCE The modeling of SDOH as multivariate indices rather than as a singular deprivation index may better capture the complexity and spatial heterogeneity underlying SDOH. During a time of increased attention to SDOH, this analysis may provide actionable information for key stakeholders with respect to the focus of interventions.
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Affiliation(s)
- Marynia Kolak
- Center for Spatial Data Science, Searle Chemistry Laboratory, University of Chicago, Chicago, Illinois
| | - Jay Bhatt
- Center for Health Innovation, American Hospital Association, Chicago, Illinois
| | - Yoon Hong Park
- Center for Spatial Data Science, Searle Chemistry Laboratory, University of Chicago, Chicago, Illinois
| | - Norma A. Padrón
- Center for Health Innovation, American Hospital Association, Chicago, Illinois
| | - Ayrin Molefe
- Center for Health Innovation, American Hospital Association, Chicago, Illinois
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239
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Gjorgjev D, Dimovska M, Morris G, Howie J, Borota Popovska M, Topuzovska Latkovikj M. How Good Is our Place-Implementation of the Place Standard Tool in North Macedonia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 17:E194. [PMID: 31892126 PMCID: PMC6981766 DOI: 10.3390/ijerph17010194] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 12/12/2022]
Abstract
This study describes the implementation, in North Macedonia, of a "tool", initially devised in Scotland, to generate community and stakeholder discussion about the places in which they live and notably a place's capacity to generate health wellbeing and greater equity among citizens. In this study, the "place standard tool" (PST) is viewed from the perspective of creating places which can deliver a triple win of health and wellbeing, equity, and environmental sustainability. Skopje, North Macedonia's capital, inevitably differs economically, culturally, and politically from Scotland, thus providing an opportunity to augment existing knowledge on adaptability of the tool in shaping agendas for policy and action. Тhe PST was tested through seminars with selected focus groups and an online questionnaire. Over 350 respondents were included. Information on priorities enabled the distillation of suggestions for improvement and was shared with the Mayor and municipal administration. Skopje citizens valued an approach which solicited their views in a meaningful way. Specific concerns were expressed relating to heavy traffic and related air and noise pollution, and care and maintenance of places and care services. Responses varied by geographic location. Application of the PST increased knowledge and confidence levels among citizens and enthusiasm for active involvement in decision making. Effective implementation relies heavily on: good governance and top-level support; excellent organization and good timing; careful training of interviewers and focus group moderators; and on prior knowledge of the participants/respondents.
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Affiliation(s)
- Dragan Gjorgjev
- Institute of Public Health of the Republic of North Macedonia, 1000 Skopje, North Macedonia;
| | - Mirjana Dimovska
- Institute of Public Health of the Republic of North Macedonia, 1000 Skopje, North Macedonia;
| | - George Morris
- European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD, UK;
| | - John Howie
- NHS Health Scotland, Meridian Court, 5 Cadogan Street, Glasgow, Scotland G2 6QE, UK;
| | - Mirjana Borota Popovska
- Institute for Sociological, Political and Juridical Research, Skopje, University “Ss. Cyril and Methodius” 1000 Skopje, North Macedonia; (M.B.P.); (M.T.L.)
| | - Marija Topuzovska Latkovikj
- Institute for Sociological, Political and Juridical Research, Skopje, University “Ss. Cyril and Methodius” 1000 Skopje, North Macedonia; (M.B.P.); (M.T.L.)
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240
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Namin S, Xu W, Zhou Y, Beyer K. The legacy of the Home Owners' Loan Corporation and the political ecology of urban trees and air pollution in the United States. Soc Sci Med 2019; 246:112758. [PMID: 31884239 DOI: 10.1016/j.socscimed.2019.112758] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/15/2019] [Accepted: 12/19/2019] [Indexed: 10/25/2022]
Abstract
This study examines the persistent impacts of historical racebased discriminatory housing policies on contemporary urban environments in the United States. Specifically, we examine the relationships between Home Owners' Loan Corporation (HOLC) grades assigned to neighborhoods in the 1930s and the current distribution of tree canopy and level of exposure to air pollution hazards. Our results indicate a clear gradient in tree canopy by HOLC grade, with better neighborhood grades associated with significantly higher percentage of tree canopy coverage. The pattern also exists for airborne carcinogens and respiratory hazards, with worse neighborhood grades associated with significantly higher hazards exposure. Our findings indicate that early 20th century discriminatory housing policies exert a contemporary influence on patterns of green space exposure in American cities, with implications for health and health inequities. Our findings suggest that, in order to achieve equitable access to the benefits of urban greenspace, we must acknowledge these historical influences and consider policies and practices that directly counter these influences, for example, through targeted greenspace development in areas historically identified as unfit for investment.
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Affiliation(s)
- S Namin
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
| | - W Xu
- Center for Demography of Health and Aging, University of Wisconsin Madison, Madison, WI, USA
| | - Y Zhou
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
| | - K Beyer
- Institute for Health & Equity, Medical College of Wisconsin, Milwaukee, WI, USA
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241
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Jessel S, Sawyer S, Hernández D. Energy, Poverty, and Health in Climate Change: A Comprehensive Review of an Emerging Literature. Front Public Health 2019; 7:357. [PMID: 31921733 PMCID: PMC6920209 DOI: 10.3389/fpubh.2019.00357] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 11/11/2019] [Indexed: 11/25/2022] Open
Abstract
Household energy is increasingly vital for maintaining good health. Unaffordable and inadequate household energy presents adverse consequences that are amplified by poverty and a changing climate. To date, the connections between energy, socioeconomic disadvantage, and well-being are generally underappreciated, and household energy connection with climate change is under-researched. Building on the energy insecurity framework, this review explores literature related to household energy, poverty, and health in order to highlight the disproportionate burdens borne by vulnerable populations in adequately meeting household energy needs. This paper is based on a comprehensive review of books, peer-reviewed articles, and reports published between 1990 and 2019, identified via databases including JSTOR and PubMed. A total of 406 publications were selected as having potential for full review, 203 received full review, and 162 were included in this paper on the basis of set inclusion criteria. From the literature review, we created an original heuristic model that describes energy insecurity as either acute or chronic, and we further explore the mediators and pathways that link energy insecurity to health. In the discussion, we posit that the extant literature does not sufficiently consider that vulnerable communities often experience energy insecurity bundled with other hardships. We also discuss energy, poverty, and health through the lens of climate change, making the criticism that most research on household energy does not consider climate change. This evidence is important for enhancing research in this field and developing programmatic and policy interventions as they pertain to energy access, affordability, and health, with special emphasis on vulnerable populations, climate change, and social inequality.
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Affiliation(s)
- Sonal Jessel
- Helibrunn Department of Population and Family Health, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Samantha Sawyer
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Diana Hernández
- Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
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242
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Majombozi Z. Care, contagion and the good mother: narratives of motherhood, tuberculosis and healing. ANTHROPOLOGY SOUTHERN AFRICA 2019. [DOI: 10.1080/23323256.2019.1608276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Ziyanda Majombozi
- School of African and Gender Studies, Anthropology and Linguistics, University of Cape Town, Cape Town, South Africa
- Current Affiliation: Anthropology and Archaeology, University of Pretoria, Pretoria, South Africa
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243
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Samuel LJ, Szanton SL, Seplaki CL, Cudjoe TKM, Thorpe RJ, Agree EM. Longitudinal and reciprocal associations between financial strain, home characteristics and mobility in the National Health and Aging Trends Study. BMC Geriatr 2019. [PMID: 31791252 DOI: 10.1186/s12877‐019‐1340‐7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Older adults need homes that suit their physical capacity. Financial strain may limit home repairs and modifications and prompt relocations; repairing, relocating or modifying may increase financial strain. Likewise, reciprocal relationships may exist between financial strain and home characteristics and mobility; financial strain and home characteristics may influence mobility and mobility declines may increase financial strain, limit home repairs and modifications and prompt relocations. We test cross-lagged associations between financial strain, home disorder, relocation, home modifications and mobility. METHODS In the National Health and Aging Trends Study, ability to complete a walking test, speed among those able to complete, financial strain, home disorder, relocating and modifying the home were recorded annually for 3 years (2012-2014). Structural equation models separately examined ability to walk and walking speed among those able, accounting for sociodemographic characteristics, social support, health prior health characteristics and autoregressive effects. Sampling weights accounted for the complex survey design and non-response over time. RESULTS In both models (n = 3234 and n = 2467), financial strain predicted greater home disorder and vice versa, but cross-lagged associations were not found with relocating and modifications. Greater home disorder predicted lower odds of ability to walk and slower speed among those able. Financial strain and home modifications predicted lower odds of ability to walk. Also, faster walking speed predicted lower odds of subsequent financial strain and lower subsequent home disorder scores and ability to walk predicted less subsequent home disorder and lower odds of relocating. CONCLUSIONS Home disorder links financial strain with reduced mobility in a national sample of U.S. older adults. Cross-lagged associations between financial strain and home disorder and between home disorder and mobility suggest reciprocal effects that may accumulate over time. Also, financial strain, reduced mobility, relocations and modifications predicted greater home disorder. Together, these results highlight home disorder as a social determinant of mobility for older adults. Greater attention should be given to repairing and modifying home environments and supporting stable housing for older adults with financial strain.
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Affiliation(s)
- L J Samuel
- Johns Hopkins University School of Nursing, 525 North Wolfe St., Rm 426, Baltimore, MD, 21205, USA.
| | - S L Szanton
- Department of Health Policy and Management, Johns Hopkins University School of Nursing and Bloomberg School of Public Health, Baltimore, USA
| | - C L Seplaki
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, USA
| | - T K M Cudjoe
- Department of Medicine, Johns Hopkins Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Baltimore, USA
| | - R J Thorpe
- Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, and Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - E M Agree
- Department of Sociology and Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, Johns Hopkins University Krieger School of Arts and Sciences, Baltimore, USA
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244
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Samuel LJ, Szanton SL, Seplaki CL, Cudjoe TKM, Thorpe RJ, Agree EM. Longitudinal and reciprocal associations between financial strain, home characteristics and mobility in the National Health and Aging Trends Study. BMC Geriatr 2019; 19:338. [PMID: 31791252 PMCID: PMC6888936 DOI: 10.1186/s12877-019-1340-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Accepted: 10/31/2019] [Indexed: 11/12/2022] Open
Abstract
Background Older adults need homes that suit their physical capacity. Financial strain may limit home repairs and modifications and prompt relocations; repairing, relocating or modifying may increase financial strain. Likewise, reciprocal relationships may exist between financial strain and home characteristics and mobility; financial strain and home characteristics may influence mobility and mobility declines may increase financial strain, limit home repairs and modifications and prompt relocations. We test cross-lagged associations between financial strain, home disorder, relocation, home modifications and mobility. Methods In the National Health and Aging Trends Study, ability to complete a walking test, speed among those able to complete, financial strain, home disorder, relocating and modifying the home were recorded annually for 3 years (2012–2014). Structural equation models separately examined ability to walk and walking speed among those able, accounting for sociodemographic characteristics, social support, health prior health characteristics and autoregressive effects. Sampling weights accounted for the complex survey design and non-response over time. Results In both models (n = 3234 and n = 2467), financial strain predicted greater home disorder and vice versa, but cross-lagged associations were not found with relocating and modifications. Greater home disorder predicted lower odds of ability to walk and slower speed among those able. Financial strain and home modifications predicted lower odds of ability to walk. Also, faster walking speed predicted lower odds of subsequent financial strain and lower subsequent home disorder scores and ability to walk predicted less subsequent home disorder and lower odds of relocating. Conclusions Home disorder links financial strain with reduced mobility in a national sample of U.S. older adults. Cross-lagged associations between financial strain and home disorder and between home disorder and mobility suggest reciprocal effects that may accumulate over time. Also, financial strain, reduced mobility, relocations and modifications predicted greater home disorder. Together, these results highlight home disorder as a social determinant of mobility for older adults. Greater attention should be given to repairing and modifying home environments and supporting stable housing for older adults with financial strain.
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Affiliation(s)
- L J Samuel
- Johns Hopkins University School of Nursing, 525 North Wolfe St., Rm 426, Baltimore, MD, 21205, USA.
| | - S L Szanton
- Department of Health Policy and Management, Johns Hopkins University School of Nursing and Bloomberg School of Public Health, Baltimore, USA
| | - C L Seplaki
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, USA
| | - T K M Cudjoe
- Department of Medicine, Johns Hopkins Center on Aging and Health, Division of Geriatric Medicine and Gerontology, Baltimore, USA
| | - R J Thorpe
- Hopkins Center for Health Disparities Solutions, Bloomberg School of Public Health, and Department of Health, Behavior and Society, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - E M Agree
- Department of Sociology and Johns Hopkins Bloomberg School of Public Health, Department of Population, Family and Reproductive Health, Johns Hopkins University Krieger School of Arts and Sciences, Baltimore, USA
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245
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Household Contamination with Methamphetamine: Knowledge and Uncertainties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234676. [PMID: 31771211 PMCID: PMC6926576 DOI: 10.3390/ijerph16234676] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/15/2019] [Accepted: 11/16/2019] [Indexed: 12/12/2022]
Abstract
Contamination of residential homes with methamphetamine is an emerging issue of significant concern to public health. Cooking or smoking methamphetamine in a residential property contaminates the house, furnishings and personal possessions within it, with subsequent exposure through ingestion, dermal absorption and/or inhalation causing adverse health effects. Current guidelines identifying levels of methamphetamine contamination that require remediation vary between countries. There is also no international standard protocol for measuring levels of contamination and research has shown that different materials give rise to different recovery rates of methamphetamine. There are a number of currently used remediation methods; however, they have varying levels of success with limited studies comparing their long-term efficacies. Most importantly, there are few guidelines available that are based on a transparent, health risk-based approach, and there are many uncertainties on exposures and health effects, making it difficult to ensure the health of people residing in homes that have been used to cook or smoke methamphetamine are sufficiently protected. This manuscript presents the current state of knowledge regarding the contamination of residential homes with methamphetamine and identifies the current gaps in knowledge and priority areas for future research. The current regulatory approach to public health protection associated with exposure to residential premises contaminated with methamphetamine in Australia, New Zealand and the USA is also discussed.
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246
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The Effect of High Occupancy Density on IAQ, Moisture Conditions and Energy Use in Apartments. ENERGIES 2019. [DOI: 10.3390/en12234454] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Apartments built in Sweden during the record years 1961–1975 with the aim to remedy the housing shortage and abolish poor standards, were designed for a normal-sized family of 2–4 persons. The mechanical ventilation system, if existing, was primarily designed to ensure an air exchange in the apartment according to Swedish building regulations. During the last few years, the number of overcrowded apartments has increased due to housing shortage in general but also due to migration. Another aspect is that the ventilation in many apartments built during the record years is already insufficient at normal occupant load. The question is how doubling or tripling the number of occupants and thus, the moisture load will affect the risk of bad air quality and moisture damage. To find out, simulations were made to estimate whether it is possible to obtain sufficient air quality and low risk of moisture damage by only increasing the ventilation rates in existing systems or introducing new ventilation systems with and without heat recovery and what the consequence would be in terms of the additional energy demand. Measurements from earlier studies of CO2 and moisture supply in Swedish apartment buildings were used as input data.
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247
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Forrester SN, Gallo JJ, Whitfield KE, Thorpe RJ. A Framework of Minority Stress: From Physiological Manifestations to Cognitive Outcomes. THE GERONTOLOGIST 2019; 59:1017-1023. [PMID: 30169640 PMCID: PMC6858824 DOI: 10.1093/geront/gny104] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Indexed: 12/31/2022] Open
Abstract
Cognitive impairment and dementia continue to threaten the aging population. Although no one is immune, certain groups, namely black older persons, are more likely to have a diagnosis of certain dementias. Because researchers have not found a purely biological reason for this disparity, they have turned to a biopsychosocial model. Specifically, black persons in the United States are more likely to live with social conditions that affect their stress levels which in turn affect physiological regulation leading to conditions that result in higher levels of cognitive impairment or dementia. Here we discuss some of these social conditions such as discrimination, education, and socioeconomic status, and how physiological dysregulation, namely allostatic load that can lead to cognitive impairment and dementia in black persons especially.
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Affiliation(s)
- Sarah N Forrester
- Quantitative Health Sciences, University of Massachusetts Medical School, Worcester
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | - Roland J Thorpe
- Departmnet of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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248
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Baker E, Pham NTA, Daniel L, Bentley R. How Does Household Residential Instability Influence Child Health Outcomes? A Quantile Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4189. [PMID: 31671903 PMCID: PMC6862481 DOI: 10.3390/ijerph16214189] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Revised: 10/24/2019] [Accepted: 10/24/2019] [Indexed: 01/09/2023]
Abstract
At the core of housing and welfare research is a premise that stable residential environments are important to children's health and development. The relationship between housing stability and health outcomes for children is, however, complex; stable housing situations are sometimes associated with poorer health outcomes, and some children may be more or less resilient to residential instability. The Longitudinal Study of Australian Children (LSAC) dataset enables us to longitudinally follow the housing and health of more than 10,000 children and their families. We employ a quantile analysis technique, a currently underutilized tool for testing associations across the distribution of an outcome, to test whether exposure to housing instability has a differential impact on children's health dependent on their initial health status. Our findings suggest that the health outcomes of residential instability are highly dependent on children's initial health status.
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Affiliation(s)
- Emma Baker
- School of Architecture and Built Environment, The University of Adelaide, Adelaide 5005, Australia.
| | - Ngoc Thien Anh Pham
- School of Architecture and Built Environment, The University of Adelaide, Adelaide 5005, Australia.
| | - Lyrian Daniel
- School of Architecture and Built Environment, The University of Adelaide, Adelaide 5005, Australia.
| | - Rebecca Bentley
- Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne 3053, Australia.
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249
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Habib RR, Ziadee M, Abi Younes E, El Asmar K, Jawad M. The association between living conditions and health among Syrian refugee children in informal tented settlements in Lebanon. J Public Health (Oxf) 2019; 42:e323-e333. [DOI: 10.1093/pubmed/fdz108] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/05/2019] [Accepted: 08/07/2019] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
This cross-sectional study explores the relationship between housing, social wellbeing, access to services and health among a population of Syrian refugee children in Lebanon.
Methods
We surveyed 1902 Syrian refugee households living in informal tented settlements in Lebanon in 2017. Logistic regressions assessed relationships between housing problems, socioeconomic deprivation, social environment and health.
Results
Of the 8284 children in the study, 33.0% had at least one health problem. A considerable number of households (43.1%) had > 8 housing problems. Children in these households had higher odds to have three or more health problems compared to children in households with < 6 housing problems (adjusted odds ratio [AOR], 2.39; confidence interval [CI], 1.50–3.81). Nearly three-quarters (74.3%) of households were severely food insecure. Children in these households had higher odds to have one health problem than those in food secure households (AOR, 1.75; CI, 1.11–2.76). There was a significant positive association between households that reported being unhappy with their neighbourhood and the number of children with health problems in those households.
Conclusions
This study highlights the association between the physical and social living conditions and refugee children’s health. Without multidimensional interventions that consider improvements to living conditions, the health of young Syrian refugees will continue to worsen.
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Affiliation(s)
- Rima R Habib
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Micheline Ziadee
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elio Abi Younes
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Khalil El Asmar
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Mohammed Jawad
- Public Health Policy Evaluation Unit, Imperial College London, London, United Kingdom
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250
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Curtis DS, Fuller-Rowell TE, Vilches S, Vonasek J, Wells NM. Associations between local government expenditures and low birth weight incidence: Evidence from national birth records. Prev Med Rep 2019; 16:100985. [PMID: 31516818 PMCID: PMC6734050 DOI: 10.1016/j.pmedr.2019.100985] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 08/05/2019] [Accepted: 08/29/2019] [Indexed: 12/26/2022] Open
Abstract
Local governments play an integral role in providing public services to their residents, yet the population health benefits are frequently overlooked, especially when services are outside the traditional health domain. With data from the U.S. Census of Governments and national birth records (spanning from 1992 to 2014), we examined whether local government expenditures on parks and recreation services (PRS) and housing and community development (HCD) predicted county low birth weight outcomes (population incidence and black-white disparities). Hypotheses were tested using bias-corrected county-by-period fixed effects models in a sample of 956 U.S. counties with a total of 3619 observations (observations were defined as three-year pooled estimates), representing 24 million births. Adjusting for prior county low birth weight incidence, levels of total operational, health, and hospital expenditures, and time-varying county sociodemographics, an increase in per capita county PRS expenditures of $50 was associated with 1.25 fewer low birth weight cases per 1000. Change in county HCD expenditures was not associated with low birth weight incidence, and, contrary to hypotheses, neither expenditure type was linked to county black-white disparities. Further examination of the benefits to birth outcomes from increasing parks and recreation services is warranted. Rising parks and recreation expenditures are linked to declining low birth weight. Housing and community expenditures are not associated with low birth weight. ‘Health’ was the only expenditure type linked to black-white perinatal disparities. Benefits of parks and recreation services may include healthier birth outcomes.
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Affiliation(s)
- David S Curtis
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT 84112, United States of America
| | - Thomas E Fuller-Rowell
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849, United States of America
| | - Silvia Vilches
- Department of Human Development and Family Studies, Auburn University, Auburn, AL 36849, United States of America
| | - Joseph Vonasek
- Department of Political Science, Auburn University, Auburn, AL 36849, United States of America
| | - Nancy M Wells
- Design + Environmental Analysis Department, Cornell University, Ithaca, NY 14853, United States of America
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