Understanding the relationship between alcohol outlet density and life expectancy in Baltimore City: The role of community violence and community disadvantage

Racial and Ethnic Disparities in Perioperative Health Care Among Patients Undergoing Cardiac Surgery: JACC State-of-the-Art Review

There has been little progress in reducing health care disparities since the 2003 landmark Institute of Medicine's report Unequal Treatment. Despite the higher burden of cardiovascular disease in underrepresented racial and ethnic groups, they have less access to cardiologists and cardiothoracic surgeons, and have higher rates of morbidity and mortality with cardiac surgical interventions. This review summarizes existing literature and highlights disparities in cardiovascular perioperative health care. We propose actionable solutions utilizing multidisciplinary perspectives from cardiology, cardiac surgery, cardiothoracic anesthesiology, critical care, medical ethics, and health disparity experts. Applying a health equity lens to multipronged interventions is necessary to eliminate the disparities in perioperative health care among patients undergoing cardiac surgery.

Linking Historical Discriminatory Housing Patterns to the Contemporary Alcohol Environment

Research on alcohol outlet density consistently shows greater disparities in exposure in disinvested communities. Likewise, structural racism via discriminatory housing practices has created many of the issues that beset contemporary disinvested neighborhoods. Little work, however, has examined the relationship between housing practices and alcohol outlet disparities. The central premise of our work is that these discriminatory and inequitable practices create distinctions in the alcohol environment, and that such disparities have implications for work on alcohol policy. Here we link alcohol outlet density with a spatial database examining redlining, blockbusting, and gentrification in Baltimore, Maryland, and Flint, Michigan (two cities with common experiences of urban disinvestment over the last 50 years). Standard measures are used to account for the impacts of neighborhood racial, socioeconomic, and housing composition in a multilevel model. Our findings highlight that gentrification and redlining are strongly associated with alcohol outlet density, while blockbusting is not. Gentrification and redlining also frequently co-occur in inner-urban areas, while the more suburban phenomenon of blockbusting rarely overlaps with either. These findings further contextualize nascent work on structural racism in housing that illustrates important disparities along the lines of these distinct practices. Future work should consider how legacy impacts of discriminatory housing patterns impact our communities today.

A systems framework depicting how complex neighborhood dynamics and contextual factors could impact the effectiveness of an alcohol outlet zoning policy

An updated zoning policy eliminating all alcohol outlets (liquor stores) in residential districts was implemented to reduce high rates of violent crime in Baltimore City. Diverse stakeholders were engaged in group model building (GMB) activities to develop causal loop diagrams (CLDs) that elucidate the impact of the new zoning policy on crime, and more broadly, the potentially unintended social and environmental consequences of the policy. Three distinct groups, community advocates, city officials/academics, and community residents, participated in three separate GMB sessions. Three CLDs, one from each stakeholder group, were created to depict the possible outcomes of the zoning policy. Our findings offer insight into potential unintended consequences of removing liquor stores from residential areas that may undermine the policy. Community members described the need for additional supports related to mental health and substance use, opportunities for investment in the community, access to other goods and services, and community-police relations to ensure the policy achieved its intended goal of reducing violent crime. Our findings highlight the importance of timely engagement of local stakeholders to understand how complex neighborhood dynamics and contextual factors could impact the effectiveness of a zoning policy change.

Development and approbation of a tool for assessing municipal infrastructure affecting behavioral risk factors for cardiovascular and other noncommunicable diseases

Aim. To present first results of the study on the assessment of municipal infrastructure using specialized software in a pilot subject of the Russian Federation (Sverdlovsk Oblast).

Material and methods. The following infrastructure elements of four municipalities of the Sverdlovsk Oblast have been assessed in the period from January to March 2022: sports facilities, grocery stores, fairs/markets with fresh vegetables and fruits, alcoholic drinks in shops and supermarkets, special liquor stores, tobacco outlets, fast food restaurants). The assessment was made with specialized software developed using Open Street Map (OSM) that allows real-time recording of objects for interactive map data visualization.

Results. The density of sales outlets for tobacco, alcohol, fresh vegetables and fruits was 2,3, 3,4 and 2,4 per 1 km², respectively; the density of sports facilities, fast food and restaurants — 1,3, 0,9 and 0,5, respectively. The number of sales outlets for tobacco, alcohol, fresh vegetables and fruits per 100 thousand people was 111,6, 167,7 and 116,5, respectively, while the number of sports facilities, fast food and restaurants — 63,5, 44,1, 25,0, respectively.

Conclusion. Creation and implementation of integrated system for assessing a unified preventive environment for promoting health and maintaining a healthy lifestyle at the municipal level using a combination of objective (GIS technologies, paraclinical tests) and subjective assessment methods (personal survey), as well as the introduction of interactive maps of municipal infrastructure, will make possible use of evidence to make decisions on the development and implementation of programs for the prevention of cardiovascular diseases and health promotion, as well as their management at the regional/municipal level.

2022 Prevention of chronic non-communicable diseases in Of the Russian Federation. National guidelines

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Neighborhood environment: the impact of alcohol and tobacco outlets availability on health of people living in a certain area

Alcohol and tobacco consumption remain significant risk factors (RFs) for morbidity and mortality from noncommunicable diseases (NCDs), including cardiovascular ones, in Russia. The main risk factors contributing to NCDs in addition to traditional risk factors and lifestyle also include the neighborhood environment (NE). The term “neighborhood environment” describes the relationship between the area in immediate vicinity of a person's place of residence, environmental factors, social characteristics of the area, which can have both positive and negative effects on human health.

The aim of this review was to analyze alcohol and tobacco outlets availability as a factor effecting health of people living in a certain area.

It was demonstrated that a high density of alcohol outlets is associated with increased alcohol consumption among both adults and adolescents, with drunk driving and road traffic accidents, injuries, violent crimes, the risk of acute and chronic diseases. A high density of tobacco outlets is associated with an increase in smoking intensity among both adults and adolescents, as well as an increase of secondhand smoke, which increases the risk of NCDs.

The consumption of alcohol and tobacco is associated with a significant increase in risk of NCDs, including cardiovascular ones, and injuries, leading to disability and death. The effectiveness of measures aimed at reducing the consumption of alcohol and tobacco may be reduced due to high density of outlets selling these products. It is necessary to conduct studies aimed at assessing the outlets density and its associations with prevalence of RFs and health status of Russian population. These data will stimulate intersectoral collaboration for planning health protection strategy at municipal level.

A Spatial Analysis of Alcohol Outlet Density Type, Abandoned Properties, and Police Calls on Aggravated Assault Rates in a Northeastern U.S. City

Background: Community-based research and prevention scholarship has shown a growing interest in examining the impact of the ecological structure of neighborhoods on community violence. Ecological structures such as higher numbers of alcohol outlets and abandoned/vacant properties in geographically dense, poor, and socially isolated communities are critically important to consider. Further, disadvantaged urban communities are burdened by greater police presence with limited or no abatement in crime or violence. Purpose: Using Geographic Information Systems (GIS) mapping, spatial analysis techniques, and a negative binomial regression analyses, this study investigated the relationships between alcohol outlet density consisting of license C (i.e., combined on and off premises establishments) and license D (i.e., off premises establishments such as liquor stores), abandoned properties, and police calls to service on aggravated assault rates in a Northeastern United States urban city. Results: Negative binomial regression analysis results showed that license C alcohol outlet density count (IRR = 1.36, 95% CI = 1.08, 2.11), license D alcohol outlet density count (IRR = 1.13, 95% CI = 1.01, 1.30), abandoned property count (IRR = 1.28, 95% CI = 1.01, 2.01), and police call to service counts (IRR = 1.24, 95% CI = 1.01, 1.50) were positively associated with aggravated assault rates. Analyses controlled for census data characteristics. Conclusions: The link between alcohol outlet density and violent crime has been established in public health research. However, this study represents an important contribution in recognizing the unique relationships between license C and license D alcohol outlet density, abandoned properties, and police calls to service with aggravated assaults in an urban neighborhood. Conclusions are drawn for policy and practice.

A Spatial Analysis of Alcohol Outlet Density and Abandoned Properties on Violent Crime in Paterson New Jersey

Alcohol outlet density (AOD) and abandoned or vacant properties in under-served urban communities has received increased attention and has been linked to community violence. While previous research has examined the AOD and violent crime association, less research has investigated the relationship between abandoned properties and violent crime. Those studies that are present examining the AOD-abandoned properties-violent crime link have been plagued by flaws that include statistical weaknesses and aggregated datasets that investigated larger units such as states or countries. The present study, using Geographic Information Systems (GIS) mapping, spatial analysis techniques, and a regression-based approach examines the association between AOD and abandoned properties on violent crime, controlling for demographic characteristics, in Paterson, New Jersey. Results provide some evidence on the association between AOD and abandoned properties on violent crime, drawing conclusions for policy and practice.

Neighborhood disadvantage and firearm injury: does shooting location matter?

Background

Firearm violence is a public health problem that disparately impacts areas of economic and social deprivation. Despite a growing literature on neighborhood characteristics and injury, few studies have examined the association between neighborhood disadvantage and fatal and nonfatal firearm assault using data on injury location. We conducted an ecological Bayesian spatial analysis examining neighborhood disadvantage as a social determinant of firearm injury in Seattle, Washington.

Methods

Neighborhood disadvantage was measured using the National Neighborhood Data Archive disadvantage index. The index includes proportion of female-headed households with children, proportion of households with public assistance income, proportion of people with income below poverty in the past 12 months, and proportion of the civilian labor force aged 16 and older that are unemployed at the census tract level. Firearm injury counts included individuals with a documented assault-related gunshot wound identified from medical records and supplemented with the Gun Violence Archive between March 20, 2016 and December 31, 2018. Available addresses were geocoded to identify their point locations and then aggregated to the census tract level. Besag-York-Mollie (BYM2) Bayesian Poisson models were fit to the data to estimate the association between the index of neighborhood disadvantage and firearm injury count with a population offset within each census tract.

Results

Neighborhood disadvantage was significantly associated with the count of firearm injury in both non-spatial and spatial models. For two census tracts that differed by 1 decile of neighborhood disadvantage, the number of firearm injuries was higher by 21.0% (95% credible interval: 10.5, 32.8%) in the group with higher neighborhood disadvantage. After accounting for spatial structure, there was still considerable residual spatial dependence with 53.3% (95% credible interval: 17.0, 87.3%) of the model variance being spatial. Additionally, we observed census tracts with higher disadvantage and lower count of firearm injury in communities with proximity to employment opportunities and targeted redevelopment, suggesting other contextual protective factors.

Conclusions

Even after adjusting for socioeconomic factors, firearm injury research should investigate spatial clustering as independence cannot be able to be assumed. Future research should continue to examine potential contextual and environmental neighborhood determinants that could impact firearm injuries in urban communities.

Discrepancies in Local, State, and National Alcohol Outlet Listings: Implications for Research and Interventions

BACKGROUND

The availability of local, state, and national data on alcohol outlet density have important implications for policies and interventions aiming to reduce alcohol-related problems. High-quality data on locations of alcohol outlets is important to accurately inform community interventions and public health initiatives, but such data is often not maintained, readily available, or of sufficient quality. Objectives: This study aims to examine the discrepancies between alcohol outlet databases and how neighborhood characteristics (i.e. income, majority racial population, urbanicity) are associated with the discrepancies between databases. Methods: Data was collected from national (n = 1), local (n = 2), and state databases (n = 3). Negative binomial regression models were used to assess discrepancies in alcohol outlet count at the ZIP code level based on the data source. Results: The average density of alcohol outlets (per 1000 residents) ranged from 0.71 to 2.17 in Maryland, 1.65 to 5.17 in Wisconsin, and 1.09 to 1.22 in Oregon based on different sources of data. Findings suggest high income areas (>200% poverty level) have fewer discrepancies (IR = 0.775, p < 0.01), low income areas (below poverty level) have greater discrepancies (IR = 4.990, p < 0.01), and urban areas tend to have fewer discrepancies (IR = 0.378, p < 0.01) between datasets. Conclusion: Interventions and policies depend on valid and reliable data; researchers, policymakers, and local agencies need to collaborate to develop methods to maintain accurate and accessible data.

Is a school's neighborhood physical disorder related to its academic outcomes?

Background

Neighborhood environment for student residences has been linked to differences in academic outcomes. However, school neighborhood has not been studied as a potential additional environmental factor in academic outcomes.

Objective

The goal of this study was to explore the association between school neighborhood disorder and academic outcomes.

Methods

School neighborhood physical disorder data were paired with school academic achievement and attendance data. Using regression analyses, we examined whether academic achievement and attendance were predicted using NIfETy neighborhood physical disorder scores for the 21 schools within the boundaries of Flint.

Results

Neighborhood physical disorder was significantly negatively associated with mathematics scores (β=-7.71707, p=0.0430425), but not with English Language Arts (ELA) scores (β=-4.35, p=0.13). We found a significant curvilinear relationship between neighborhood physical disorder and attendance.

Conclusions

This study supplements existing literature by focusing on neighborhood physical disorder at the school. We found evidence that school neighborhood may impact academic achievement. These findings complement previous research showing that neighborhood of residence factors, such as structural disadvantage, impact school performance. Students exposed to economically disadvantaged neighborhoods at school, regardless of where they live, may have poorer academic skills.

Polygenic and environmental influences on the course of African Americans' alcohol use from early adolescence through young adulthood

The study examined (a) whether alcohol use subgroups could be identified among African Americans assessed from adolescence through early adulthood, and (b) whether subgroup membership was associated with the interaction between internalizing symptoms and antisocial behavior polygenic risk scores (PRSs) and environmental characteristics (i.e., parental monitoring, community disadvantage). Participants (N = 436) were initially recruited for an elementary school-based prevention trial in a Mid-Atlantic city. Youths reported on the frequency of their past year alcohol use from ages 14-26. DNA was obtained from participants at age 21. Internalizing symptoms and antisocial behavior PRSs were created based on a genome-wide association study (GWAS) conducted by Benke et al. (2014) and Tielbeek et al. (2017), respectively. Parental monitoring and community disadvantage were assessed at age 12. Four classes of past year alcohol use were identified: (a) early-onset, increasing; (b) late-onset, moderate use; (c) low steady; and (d) early-onset, decreasing. In high community disadvantaged settings, participants with a higher internalizing symptoms PRS were more likely to be in the early-onset, decreasing class than the low steady class. When exposed to elevated community disadvantage, participants with a higher antisocial behavior PRS were more likely to be in the early-onset, increasing class than the early-onset, decreasing and late-onset, moderate use classes.