1
|
Yang S, Zheng X, Hou J, Geng B, Luo L, Zhu C, Liu L, Zhu J. Rural revival: Navigating environmental engineering and technology. ENVIRONMENTAL RESEARCH 2024; 254:119164. [PMID: 38762005 DOI: 10.1016/j.envres.2024.119164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 05/20/2024]
Abstract
The necessity for global engineering and technological solutions to address rural environmental challenges is paramount, particularly in improving rural waste treatment and infrastructure. This study presents a comprehensive quantitative analysis of 3901 SCI/SSCI and 3818 Chinese CSCD papers, spanning from 1989 to 2021, using tools like Derwent Data Analyzer and VOSviewer. Our key findings reveal a significant evolution in research focus, including a 716.67% increase in global publications from 1995 to 2008 and a 154.76% surge from 2015 to 2021, highlighting a growing research interest with technological hotspots in rural revitalization engineering and agricultural waste recycling. China and the USA are pivotal, contributing 784 and 714 publications respectively. Prominent institutions such as the Chinese Academy of Sciences play a crucial role, particularly in fecal waste treatment technology. These insights advocate for enhanced policy development and practical implementations to foster inclusive and sustainable rural environments globally.
Collapse
Affiliation(s)
- Siyuan Yang
- Beijing Institute of Metrology, Beijing, 100012, China
| | - Xiangqun Zheng
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Jiaqi Hou
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, 100012, China
| | - Bing Geng
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Liangguo Luo
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Changxiong Zhu
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Liyuan Liu
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing, 100081, China
| | - Jie Zhu
- Institute of Environment and Sustainable Development in Agriculture, Chinese Academy of Agricultural Sciences, Beijing, 100081, China.
| |
Collapse
|
2
|
Kiyingi J, Mayo-Wilson LJ, Nabunya P, Kizito S, Nabayinda J, Nattabi J, Nsubuga E, Bahar OS, Namuwonge F, Nakabuye F, Nanteza F, Filippone PL, Mukasa D, Witte SS, Ssewamala FM. Examining the Intrapersonal, Interpersonal and Community Level Correlates of Access to Medical Care Among Women Employed by Sex Work in Southern Uganda: A cross-sectional Analysis of the Kyaterekera Study. AIDS Behav 2024; 28:2350-2360. [PMID: 38605251 PMCID: PMC11199097 DOI: 10.1007/s10461-024-04333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 04/13/2024]
Abstract
Women employed by sex work (WESW) experience significant gaps in accessing necessary healthcare services, leading to unmet health needs. Yet, there is a dearth of literature on the barriers to medical care access among WESW in Uganda. We used data from the Kyaterekera baseline to examine the correlates of access to medical care among WESW, defined as the ability of individuals to obtain the necessary healthcare services they require in a timely, affordable, and equitable manner. The Kyaterekera study recruited 542 WESW aged 18-58 years from Southern Uganda. We conducted a multilevel linear regression model to determine the intrapersonal (age, education level, marital status, HIV knowledge, and asset ownership), interpersonal (family cohesion and domestic violence attitudes), and community (community satisfaction, sex work stigma and distance to health facility) level correlates of access to medical care among WESW. Intrapersonal and interpersonal factors were associated with access to medical care among WESW. There was no significant association between community level factors and access to medical care. WESW with secondary education (β = 0.928, 95% CI = 0.007, 1.849) were associated with increased access to medical care. WESW with high asset ownership (β = -1.154, 95% CI= -1.903, -0.405), high family cohesion (β = -0.069, 95% CI= -0.106, -0.031), and high domestic violence attitudes (β = -0.253, 95% CI= -0.438, -0.068) were associated with decreased access to medical care. The findings emphasize the critical need for targeted family strengthening interventions to enhance family support for WESW and address domestic violence.
Collapse
Affiliation(s)
- Joshua Kiyingi
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Larissa Jennings Mayo-Wilson
- Department of Heath Behavior, Department of Maternal and Child Health, University of North Carolina, 316 Rosenau Hall, CB #7400, 135 Dauer Drive, Chapel Hill, NC, 27599, USA
| | - Proscovia Nabunya
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Samuel Kizito
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Josephine Nabayinda
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Jennifer Nattabi
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Edward Nsubuga
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Ozge Sensoy Bahar
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Flavia Namuwonge
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA
| | - Fatuma Nakabuye
- International Center for Child Health and Development (ICHAD), Masaka, Uganda
| | - Flavia Nanteza
- International Center for Child Health and Development (ICHAD), Masaka, Uganda
| | - Prema L Filippone
- Silver School of Social Work, New York University, 1 Washington Square North, New York, NY, 10003, USA
| | - Dinah Mukasa
- International Center for Child Health and Development (ICHAD), Masaka, Uganda
| | - Susan S Witte
- Columbia University School of Social, Work1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Fred M Ssewamala
- International Center for Child Health and Development (ICHAD), Washington University in St. Louis Brown School, 1 Brookings Drive, St. Louis, MO, 63130, USA.
- Brown School, Washington University in St. Louis International Center for Child Health and Development (ICHAD), Goldfarb, Room 346 Campus Box 1196, One Brookings Drive, St. Louis, MO, 63130, USA.
| |
Collapse
|
3
|
Amouzou A, Melesse DY, Wehrmeister FC, Ferreira LZ, Jiwani SS, Kassegne S, Maïga A, Faye CM, Ca T, Boerma T. Erosion of the Capital City Advantage in Child Survival and Reproductive, Maternal, Newborn, and Child Health Intervention Coverage in Sub-Saharan Africa. J Urban Health 2024:10.1007/s11524-023-00820-0. [PMID: 38767766 DOI: 10.1007/s11524-023-00820-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/08/2023] [Indexed: 05/22/2024]
Abstract
The place of residence is a major determinant of RMNCH outcomes, with rural areas often lagging in sub-Saharan Africa. This long-held pattern may be changing given differential progress across areas and increasing urbanization. We assessed inequalities in child mortality and RMNCH coverage across capital cities and other urban and rural areas. We analyzed mortality data from 163 DHS and MICS in 39 countries with the most recent survey conducted between 1990 and 2020 and RMNCH coverage data from 39 countries. We assessed inequality trends in neonatal and under-five mortality and in RMNCH coverage using multilevel linear regression models. Under-five mortality rates and RMNCH service coverage inequalities by place of residence have reduced substantially in sub-Saharan Africa, with rural areas experiencing faster progress than other areas. The absolute gap in child mortality between rural areas and capital cities and that between rural and other urban areas reduced respectively from 41 and 26 deaths per 1000 live births in 2000 to 23 and 15 by 2015. Capital cities are losing their primacy in child survival and RMNCH coverage over other urban areas and rural areas, especially in Eastern Africa where under-five mortality gap between capital cities and rural areas closed almost completely by 2015. While child mortality and RMNCH coverage inequalities are closing rapidly by place of residence, slower trends in capital cities and urban areas suggest gradual erosion of capital city and urban health advantage. Monitoring child mortality and RMNCH coverage trends in urban areas, especially among the urban poor, and addressing factors of within urban inequalities are urgently needed.
Collapse
Affiliation(s)
- Agbessi Amouzou
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA.
| | - Dessalegn Y Melesse
- Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Fernando C Wehrmeister
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Leonardo Z Ferreira
- International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
| | - Safia S Jiwani
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | | | - Abdoulaye Maïga
- Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205, USA
| | - Cheikh M Faye
- African Population and Health Research Center, Dakar, Senegal
| | - Tome Ca
- West African Health Organization, Bobo-Dioulasso, Burkina Faso
| | - Ties Boerma
- Institute for Global Public Health, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| |
Collapse
|
4
|
Zhou Y, Lu Y, Wei D, He S. Impacts of social deprivation on mortality and protective effects of greenness exposure in Hong Kong, 1999-2018: A spatiotemporal perspective. Health Place 2024; 87:103241. [PMID: 38599046 DOI: 10.1016/j.healthplace.2024.103241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/27/2024] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
Addressing health inequality is crucial for fostering healthy city development. However, there is a dearth of literature simultaneously investigating the effects of social deprivation and greenness exposure on mortality risks, as well as how greenness exposure may mitigate the adverse effect of social deprivation on mortality risks from a spatiotemporal perspective. Drawing on socioeconomic, remote sensing, and mortality record data, this study presents spatiotemporal patterns of social deprivation, population weighted greenness exposure, and all-cause and cause-specific mortality in Hong Kong. A Bayesian regression model was applied to investigate the impacts of social deprivation and greenness exposure on mortality and examine how socioeconomic inequalities in mortality may vary across areas with different greenness levels in Hong Kong from 1999 to 2018. We observed a decline in social deprivation (0.67-0.56), and an increase in greenness exposure (0.34-0.41) in Hong Kong during 1999-2018. Areas with high mortality gradually clustered in the Kowloon Peninsula and the northern regions of Hong Kong Island. Adverse impacts of social deprivation on all-cause mortality weakened in recent years (RR from 2009 to 2013: 1.103, 95%CI: 1.051-1.159, RR from 2014 to 2018: 1.041 95%CI: 0.950-1.139), while the protective impacts of greenness exposure consistently strengthened (RR from 1999 to 2003: 0.903, 95%CI: 0.827-0.984, RR from 2014 to 2018: 0.859, 95%CI: 0.763-0.965). Moreover, the adverse effects of social deprivation on mortality risks were found to be higher in areas with lower greenness exposure. These findings provide evidence of associations between social deprivation, greenness exposure, and mortality risks in Hong Kong over the past decades, and highlight the potential of greenness exposure to mitigate health inequalities. Our study provides valuable implications for policymakers to develop a healthy city.
Collapse
Affiliation(s)
- Yuxuan Zhou
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Yi Lu
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China.
| | - Di Wei
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong Special Administrative Region, China; School of Architecture and Urban Planning, Huazhong University of Science and Technology, Wuhan, China; Hubei Engineering and Technology Research Center of Urbanization, Wuhan, China.
| | - Shenjing He
- Department of Urban Planning and Design, Urban Systems Institute, And the Social Infrastructure for Equity and Wellbeing Lab, The University of Hong Kong, Hong Kong Special Administrative Region of China, China.
| |
Collapse
|
5
|
Abdel-Rahman S, Khater E, Abdel Fattah MN, Hussein WA. Social determinants of chronic diseases reporting among slum dwellers in Egypt. J Biosoc Sci 2024; 56:590-608. [PMID: 38347812 DOI: 10.1017/s0021932024000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
The high prevalence of chronic diseases in urban slums poses increasing challenges to future social and economic development for these disadvantaged areas. Assessing the health status of slum residents offers guidance for formulating appropriate policies and interventions to improve slum residents' health outcomes. This research aimed to identify the social determinants of chronic diseases reporting among slum dwellers in Egypt. A cross-sectional survey was conducted from March to December 2021 in three slum areas in Giza governorate, Egypt, including 3,500 individuals. We constructed an asset index and a welfare index to measure the economic status and living conditions of slum residents, respectively. We used these indices, along with demographic and socio-economic factors, as independent variables in the analysis. We modeled factors associated with health status using a two-level mixed logistic model to control the effects of slum areas and the potential correlation between household members. The study contributed significantly to a better understanding of the context in which slum dwellers live and the interlinkages among poor living conditions, low economic status, and health outcomes. The results showed a high rate of self-reported chronic diseases among adults aged 18 and older, reaching more than 22%, while it did not exceed 2.0% among children in the slum areas. Therefore, measuring the determinants of chronic diseases was limited to adults. The sample size was 2530 adults after excluding 970 children. The prevalence of chronic diseases among adults ranged between 16.3% in Zenin and 22.6% in Bein El Sarayat. Our findings indicated that low socio-economic status was significantly associated with reporting chronic diseases. Future policies should be dedicated to improving living conditions and providing necessary healthcare services for these vulnerable areas.
Collapse
Affiliation(s)
- Suzan Abdel-Rahman
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Elsayed Khater
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Mohamed N Abdel Fattah
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| | - Wafaa A Hussein
- Biostatistics and Demography, Faculty of Graduate Studies for Statistical Research, Cairo University, Cairo, Egypt
| |
Collapse
|
6
|
Mi J, Han X, Cao M, Pan Z, Guo J, Huang D, Sun W, Liu Y, Xue T, Guan T. The Association Between Urbanization and Electrocardiogram Abnormalities in China: a Nationwide Longitudinal Study. J Urban Health 2024; 101:109-119. [PMID: 38216823 PMCID: PMC10897075 DOI: 10.1007/s11524-023-00816-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/14/2024]
Abstract
The health effects of urbanization are controversial. The association between urbanization and reversible subclinical risks of cardiovascular diseases (e.g., electrocardiogram (ECG) abnormalities) has rarely been studied. This study aimed to assess the association between urbanization and ECG abnormalities in China based on the China National Stroke Screening Survey (CNSSS). We used changes in the satellite-measured impervious surfaces rate and nighttime light data to assess the level of urbanization. Every interquartile increment in the impervious surfaces rate or nighttime light was related to a decreased risk of ECG abnormalities, with odds ratios of 0.894 (95% CI, 0.869-0.920) or 0.809 (95% CI, 0.772-0.847), respectively. And we observed a U-shaped nonlinear exposure-response relationship curve between the impervious surfaces rate and ECG abnormalities. In conclusion, the current average level of urbanization among the studied Chinese adults remains a beneficial factor for reducing cardiovascular risks.
Collapse
Affiliation(s)
- Jiarun Mi
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Xueyan Han
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Zhaoyang Pan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Jian Guo
- Department of Cardiology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
- Medical Research Center, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Dengmin Huang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Wei Sun
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Tao Xue
- Institute of Reproductive and Child Health, National Health Commission Key Laboratory of Reproductive Health/Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Epidemiology of Major Diseases (PKU), School of Public Health, Peking University Health Science Centre, Beijing, 100191, China.
- State Environmental Protection Key Laboratory of Atmospheric Exposure, and Health Risk Management and Center for Environment and Health, Peking University, Beijing, 100871, China.
- Advanced Institute of Information Technology, Peking University, Hangzhou, 311215, China.
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
| |
Collapse
|
7
|
Ahmer Z, Atif M, Zaheer S, Adil O, Shaikh S, Shafique K. Association between residential green spaces and pregnancy outcomes: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024:1-18. [PMID: 38185100 DOI: 10.1080/09603123.2023.2299242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/20/2023] [Indexed: 01/09/2024]
Abstract
Residential exposure to greenness has shown positive influences on pregnancy outcomes like birth weight, preterm births, and small to gestational age (SGA) deliveries. We aimed to comprehensively review and investigate these associations by conducting a systematic review with meta-analysis. Relevant studies were retrieved from PubMed, EMBASE, ScienceDirect, and Google Scholar databases before June 2023. Summary effect estimates included birth weight, low birth weight (LBW), preterm births, and SGA which were calculated for 0.1 unit increase in residential greenness exposure. Overall quality of the evidence was examined through Joanna Briggs Institute (JBI) critical appraisal tool. The review included 31 articles and found a statistically significant increase in birth weight measured at 250 m buffer distance (β = 8.95, 95% CI = 1.63-16.27). Green spaces were also associated with lower odds of LBW (OR = 0.97, 95% CI = 0.96-0.98). Residential greenness had positive impacts on pregnancy outcomes that calls for emphasis on urban planning, especially in developing countries.
Collapse
Affiliation(s)
- Zaeema Ahmer
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Maria Atif
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Sidra Zaheer
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Omair Adil
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Shiraz Shaikh
- APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, Sindh, Pakistan
| | - Kashif Shafique
- School of Public Health, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| |
Collapse
|
8
|
Eze P, Idemili CJ, Lawani LO. Evaluating health systems' efficiency towards universal health coverage: A data envelopment analysis. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241235759. [PMID: 38456456 PMCID: PMC10924553 DOI: 10.1177/00469580241235759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/21/2024] [Accepted: 02/12/2024] [Indexed: 03/09/2024]
Abstract
To estimate the technical efficiency of health systems toward achieving universal health coverage (UHC) in 191 countries. We applied an output-oriented data envelopment analysis approach to estimate the technical efficiency of the health systems, including the UHC index (a summary measure that captures both service coverage and financial protection) as the output variable and per capita health expenditure, doctors, nurses, and hospital bed density as input variables. We used a Tobit simple-censored regression with bootstrap analysis to observe the socioeconomic and environmental factors associated with efficiency estimates. The global UHC index improved from the 2019 estimates, ranged from 48.4 (Somalia) to 94.8 (Canada), with a mean of 76.9 (std. dev.: ±12.0). Approximately 78.5% (150 of 191) of the studied countries were inefficient (ϕ < 1.0) with respect to using health system resources toward achieving UHC. By improving health system efficiency, low-income, lower-middle-income, upper-middle-income, and high-income countries can improve their UHC indices by 4.6%, 5.5%, 6.8%, and 4.1%, respectively, by using their current resource levels. The percentage of health expenditure spent on primary health care (PHC), governance quality, and the passage of UHC legislation significantly influenced efficiency estimates. Our findings suggests health systems inefficiency toward achieving UHC persists across countries, regardless of their income classifications and WHO regions, as well as indicating that using current level of resources, most countries could boost their progress toward UHC by improving their health system efficiency by increasing investments in PHC, improving health system governance, and where applicable, enacting/implementing UHC legislation.
Collapse
Affiliation(s)
- Paul Eze
- Penn State University, University Park, PA, USA
| | | | | |
Collapse
|
9
|
Curtis MG, Floresca YB, Davoudpour S, Xu J, Phillips G. Patterns of COVID-19 related lifestyle disruptions and their associations with mental health outcomes among youth and young adults. JOURNAL OF MOOD AND ANXIETY DISORDERS 2023; 4:100029. [PMID: 38125785 PMCID: PMC10732581 DOI: 10.1016/j.xjmad.2023.100029] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
The COVID-19 pandemic is a socionatural disaster that has disrupted the lives of individuals, families, and communities. Youth and young adults (YYA) were uniquely vulnerable to the proximal mental health effects of the pandemic; however, few studies have examined the long-term mental health effects of the pandemic. In the present study, we sought to (a) identity distinctive profiles of COVID-related lifestyle disruptions experienced by YYA, (b) investigate sociodemographic characteristics correlates of profile membership, and (c) examine the extent to which profile membership was prospectively associated with changes in depressive and anxiety symptoms. Hypothesis were tested using latent profile analysis with data from 1055 YYA collected across two time-points, 6-months apart. Results produced a three-class model: low- (11%), moderate- (61%), and high-levels of (28%) disruption. Members of the high levels of disruption group were more likely to identify as Black or Latinx American, bisexual/pansexual, or as transgender or gender diverse in comparison to the low levels of disruption group. Inclusion in the high levels of disruption group was associated with increases in depressive and anxiety symptoms from T1 to T2. YYA from multiple marginalize communities (i. e. those who identified as both racial/ethnic and sexual/gender minorities) experienced the greatest levels of lifestyle disruption related to COVID-19. Consequently, disruptive effects of the COVID-19 pandemic prospectively eroded their mental health. YYA are in urgent need of developmentally appropriate resources to effectively recovery from the pandemic.
Collapse
Affiliation(s)
- Michael G. Curtis
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Ysabel Beatrice Floresca
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Shahin Davoudpour
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Jiayi Xu
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
| | - Gregory Phillips
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, USA
- Division of Public Health Practice, Department of Preventive Medicine, Feinberg School of Medicine Northwestern University, USA
| |
Collapse
|
10
|
Meehan DE, Grunseit A, Condie J, HaGani N, Merom D. Social-ecological factors influencing loneliness and social isolation in older people: a scoping review. BMC Geriatr 2023; 23:726. [PMID: 37946155 PMCID: PMC10636946 DOI: 10.1186/s12877-023-04418-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/18/2023] [Indexed: 11/12/2023] Open
Abstract
There are growing calls from researchers and policy makers to redefine loneliness and social isolation (SI) as public health issues, and to move towards a transdisciplinary, systems-based approach, due to their association with significant health risks, particularly in older people. Research about loneliness and SI in older people has typically adopted a narrow focus, evaluating effects of individual and inter-personal factors on these experiences. Less is known about the community and societal influences that may be used to inform public health interventions. We conducted a scoping review applying Joanna Briggs Institute methodology and the social-ecological model framework in order to: i) identify the available evidence for the influence of the community and societal factors on loneliness and SI as experienced by older people; ii) examine how quantitative research about community- and societal-level factors of loneliness and SI in the older population is conducted; and iii) identify current knowledge gaps in relation to the use of the social-ecological model in this area. A total of 52 articles from 30 countries met the inclusion criteria, including 33 observational studies, primarily cross-sectional (88%), and 19 interventions, mostly (89%) pre-post evaluations. The majority of included articles measured loneliness only (n = 34, 65%), while 11 measured both loneliness and SI (21%). To measure these outcomes validated scales were frequently used. Eighteen community/societal factors were investigated in relation to loneliness and/or SI, most commonly neighbourhood safety, access to public third-places and cultural practices. Three societal-level interventions were found: two campaigns to reduce ageism and one which explored the impact of free public transport. Community-based interventions were either educational or enlisted volunteers to foster connections. There is a need for longitudinal studies to better understand the mechanisms through which community- and societal- level factors affect loneliness and SI, which in turn will guide interventions that utilise the social-ecological framework for these issues.
Collapse
Affiliation(s)
- Drew Eleanor Meehan
- School of Health Sciences, Western Sydney University, Campbelltown, Australia.
| | - Anne Grunseit
- School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Jenna Condie
- School of Social Sciences, Western Sydney University, Paramatta, Australia
| | - Neta HaGani
- Prevention Research Collaboration, School of Public Health, University of Sydney, Camperdown, Australia
| | - Dafna Merom
- School of Health Sciences, Western Sydney University, Campbelltown, Australia
| |
Collapse
|
11
|
Domingues LCSM, Cavallazzi RL. [Urban health, the right to the city, and the communities of Manguinhos in Rio de Janeiro]. HISTORIA, CIENCIAS, SAUDE--MANGUINHOS 2023; 30Suppl 2:e2023063. [PMID: 37971067 PMCID: PMC10637581 DOI: 10.1590/s0104-59702023000100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/26/2023] [Indexed: 11/19/2023]
Abstract
This article proposes a critical reading of the urbanistic and social historical context of the communities of Manguinhos, considering the field of urban health as a theoretical and methodological foundation based on the paradigm of the social commitment to health and the right to the city. Our demarcation of this analysis to identify the critical processes in the social commitment to health considered the relevance of overcoming housing needs as an indispensable condition for the right to the city and to health. The fact that these processes persist, even after the vast investments made in Manguinhos, indicates the need to review related public policies and their effective implementation to improve conditions for this population.
Collapse
Affiliation(s)
| | - Rosângela Lunardelli Cavallazzi
- Professora e pesquisadora, Programa de Pós-graduação em Urbanismo/Universidade Federal do Rio de Janeiro
- Programa de Pós-graduação em Direito/Pontifícia Universidade Católica do Rio de Janeiro.
- Professora e pesquisadora, Programa de Pós-graduação em Urbanismo/Universidade Federal do Rio de Janeiro
- Programa de Pós-graduação em Direito/Pontifícia Universidade Católica do Rio de Janeiro.
| |
Collapse
|
12
|
Wikkeling-Scott LF, Gharipour M, Mohagheghi S. The effects of COVID-19 on African American communities in Baltimore's health enterprise zones: a mixed-methods examination. BMC Public Health 2023; 23:1873. [PMID: 37759208 PMCID: PMC10536730 DOI: 10.1186/s12889-023-16782-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/15/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The CoVID-19 pandemic underscored effects of community resources on the built environment, health and health outcomes. The purpose of this study was to conduct community-engaged research and examine aspects of health, and access to healthcare from the voices of community members, as a foundation for improving health equity through the built environment. METHODS This study utilized a convergent mixed methods design that included surveys and semi-structured interviews conducted from July 2021 to August 2022 to examine the impact of limited community resources, such as community health clinics on participants during the CoVID-19 pandemic. A convenient sample of 345 male and female African American participants represented five zip codes (21215, 21216, 21217, 21223, and 21229) in with the highest impact from CoVID 19, in Baltimore, Maryland. Quantitative and qualitative data were integrated to describe how the two types supported one another in health, healthcare and healthcare access. RESULTS More than half of all participants reported satisfaction with overall health, quality of healthcare provided and access to health care services. However, results indicated extreme differences in factors related to health and wellness after, as comparted to before the onset of the pandemic, Semi-structured interviews, expanded on overall community health, highlighting that overall satisfaction with health does not equal satisfaction with health-related resources and suggested participants felt frustrated and left out of much-needed community health resources to improve health and mental health services for all ages, nutrition services and community activities that make communities thrive. Data integration provided a more realistic view of what participants really experience, due to the expanded analysis of semi-structured interviews, and indicated quantitative and qualitative data did not always support each other. CONCLUSIONS Future research to improve the built environment, and to address historic health inequities, will require ongoing community engagement to better understand community needs. This study results encourage ongoing research to expand resources for community-engaged research and interventions. Researchers must remain cognoscente of changing needs, and persistent disparities that can only be addressed if policies, supported by these results, are introduced to make equitable investments to forge an environment where healthy communities thrive.
Collapse
Affiliation(s)
- Ludmila F Wikkeling-Scott
- Public Health Department, School of Community Health and Policy, Morgan State University, E. 1700 Cold Spring Lane, Baltimore, MD, 21251, USA.
| | - Mohammad Gharipour
- Architecture Program, School of Architecture, Planning and Historic Preservation, University of Maryland, 3835 Campus Drive, College Park, MD, 20742, USA
| | - Salman Mohagheghi
- Electrical Engineering Department, Colorado School of Mines, 1610 Illinois Street, Golden, CO, 80401, USA
| |
Collapse
|
13
|
Nampijja M, Langat N, Oloo L, Amboka P, Okelo K, Muendo R, Habib S, Kiyeng M, Ray A, Abboah-Offei M, Kitsao-Wekulo P, Kimani-Murage E, Li J, Elsey H. The feasibility, acceptability, cost and benefits of a "communities of practice" model for improving the quality of childcare centres: a mixed-methods study in the informal settlements in Nairobi. Front Public Health 2023; 11:1194978. [PMID: 37588124 PMCID: PMC10426909 DOI: 10.3389/fpubh.2023.1194978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 07/13/2023] [Indexed: 08/18/2023] Open
Abstract
Background Informal childcare centres have mushroomed in the informal settlements of Nairobi, Kenya to meet the increasing demand. However, centre providers are untrained and the facilities are below standard putting children at risk of poor health and development. We aimed to co-design and test the feasibility, acceptability, cost and potential benefits of a communities of practice (CoP) model where trained community health volunteers (CHVs) provide group training sessions to build skills and improve practices in informal childcare centres. Methods A CoP model was co-designed with sub-county health teams, centre providers and parents with inputs from Kidogo, government nutritionists and ECD experts and implemented in 68 childcare centres by trained CHVs. Its feasibility and potential benefits were measured quantitatively and qualitatively. Centre provider (n = 68) and CHV (n = 20) knowledge and practice scores before and after the intervention were assessed and compared. Intervention benefits were examined using linear regressions adjusting for potential confounding factors. We conducted in-depth interviews with 10 parents, 10 CHVs, 10 centre providers and 20 local government officials, and two focus groups with CHVs and centre providers. Qualitative data were analysed, focusing on feasibility, acceptability, potential benefits, challenges and ideas for improvement. Cost for delivering and accessing the intervention were examined. Results The intervention was acceptable and feasible to deliver within existing government community health systems; 16 CHVs successfully facilitated CoP sessions to 58 centre providers grouped into 13 groups each with 5-6 centre providers, each group receiving four sessions representing the four modules. There were significant improvements in provider knowledge and practice (effect size = 0.40; p < 0.05) and quality of centre environment (effect size = 0.56; p < 0.01) following the intervention. CHVs' scores showed no significant changes due to pre-existing high knowledge levels. Qualitative interviews also reported improvements in knowledge and practices and the desire among the different participants for the support to be continued. The total explicit costs were USD 22,598 and the total opportunity costs were USD 3,632 (IQR; USD 3,570, USD 4,049). Conclusion A simple model delivered by CHVs was feasible and has potential to improve the quality of informal childcare centres. Leveraging these teams and integration of the intervention into the health system is likely to enable scale-up and sustainability in Kenya and similar contexts.
Collapse
Affiliation(s)
| | - Nelson Langat
- African Population and Health Research Center, Nairobi, Kenya
| | - Linda Oloo
- African Population and Health Research Center, Nairobi, Kenya
| | - Patrick Amboka
- African Population and Health Research Center, Nairobi, Kenya
| | - Kenneth Okelo
- African Population and Health Research Center, Nairobi, Kenya
| | - Ruth Muendo
- African Population and Health Research Center, Nairobi, Kenya
| | | | | | - Anna Ray
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | - Mary Abboah-Offei
- Department of Health Sciences, University of York, Heslington, United Kingdom
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | | | | | - Jinshuo Li
- Department of Health Sciences, University of York, Heslington, United Kingdom
| | - Helen Elsey
- Department of Health Sciences, University of York, Heslington, United Kingdom
| |
Collapse
|
14
|
Kannoth S, Chung SE, Tamakloe KD, Albrecht SS, Azan A, Chambers EC, Sheffield PE, Thompson A, Woo Baidal JA, Lovinsky-Desir S, Stingone JA. Neighborhood environmental vulnerability and pediatric asthma morbidity in US metropolitan areas. J Allergy Clin Immunol 2023; 152:378-385.e2. [PMID: 36990323 PMCID: PMC10524145 DOI: 10.1016/j.jaci.2023.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/13/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Research suggests demographic, economic, residential, and health-related factors influence vulnerability to environmental exposures. Greater environmental vulnerability may exacerbate environmentally related health outcomes. We developed a neighborhood environmental vulnerability index (NEVI) to operationalize environmental vulnerability on a neighborhood level. OBJECTIVE We explored the relationship between NEVI and pediatric asthma emergency department (ED) visits (2014-19) in 3 US metropolitan areas: Los Angeles County, Calif; Fulton County, Ga; and New York City, NY. METHODS We performed separate linear regression analyses examining the association between overall NEVI score and domain-specific NEVI scores (demographic, economic, residential, health status) with pediatric asthma ED visits (per 10,000) across each area. RESULTS Linear regression analyses suggest that higher overall and domain-specific NEVI scores were associated with higher annual pediatric asthma ED visits. Adjusted R2 values suggest that overall NEVI scores explained at least 40% of the variance in pediatric asthma ED visits. Overall NEVI scores explained more of the variance in pediatric asthma ED visits in Fulton County. NEVI scores for the demographic, economic, and health status domains explained more of the variance in pediatric asthma ED visits in each area compared to the NEVI score for the residential domain. CONCLUSION Greater neighborhood environmental vulnerability was associated with greater pediatric asthma ED visits in each area. The relationship differed in effect size and variance explained across the areas. Future studies can use NEVI to identify populations in need of greater resources to mitigate the severity of environmentally related outcomes, such as pediatric asthma.
Collapse
Affiliation(s)
- Sneha Kannoth
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY.
| | - Sarah E Chung
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY
| | - Kelvin D Tamakloe
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY
| | - Sandra S Albrecht
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY
| | - Alexander Azan
- Department of Population Health, New York University Langone Health, New York City, NY
| | - Earle C Chambers
- Department of Family and Social Medicine, Albert Einstein College of Medicine, Bronx, NY
| | - Perry E Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York City, NY
| | - Azure Thompson
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY
| | - Jennifer A Woo Baidal
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY
| | - Stephanie Lovinsky-Desir
- Department of Pediatrics, Vagelos College of Physicians and Surgeons, Columbia University, New York City, NY
| | - Jeanette A Stingone
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, NY
| |
Collapse
|
15
|
Lai KY, Webster C, Gallacher JE, Sarkar C. Associations of Urban Built Environment with Cardiovascular Risks and Mortality: a Systematic Review. J Urban Health 2023; 100:745-787. [PMID: 37580546 PMCID: PMC10447831 DOI: 10.1007/s11524-023-00764-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2023] [Indexed: 08/16/2023]
Abstract
With rapid urbanization, built environment has emerged as a set of modifiable factors of cardiovascular disease (CVD) risks. We conducted a systematic review to synthesize evidence on the associations of attributes of urban built environment (e.g. residential density, land use mix, greenness and walkability) with cardiovascular risk factors (e.g. hypertension and arterial stiffness) and major CVD events including mortality. A total of 63 studies, including 31 of cross-sectional design and 32 of longitudinal design conducted across 21 geographical locations and published between 2012 and 2023 were extracted for review. Overall, we report moderately consistent evidence of protective associations of greenness with cardiovascular risks and major CVD events (cross-sectional studies: 12 of 15 on hypertension/blood pressure (BP) and 2 of 3 on arterial stiffness; and longitudinal studies: 6 of 8 on hypertension/BP, 7 of 8 on CVD mortality, 3 of 3 on ischemic heart disease mortality and 5 of 8 studies on stroke hospitalization or mortality reporting significant inverse associations). Consistently, walkability was associated with lower risks of hypertension, arterial stiffness and major CVD events (cross-sectional studies: 11 of 12 on hypertension/BP and 1 of 1 on arterial stiffness; and longitudinal studies: 3 of 6 on hypertension/BP and 1 of 2 studies on CVD events being protective). Sixty-seven percent of the studies were rated as "probably high" risk of confounding bias because of inability to adjust for underlying comorbidities/family history of diseases in their statistical models. Forty-six percent and 14% of the studies were rated as "probably high" risk of bias for exposure and outcome measurements, respectively. Future studies with robust design will further help elucidate the linkages between urban built environment and cardiovascular health, thereby informing planning policies for creating healthy cities.
Collapse
Affiliation(s)
- Ka Yan Lai
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong Special Administrative Region, China
| | - John Ej Gallacher
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| | - Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Urban Planning and Design, Faculty of Architecture, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong Special Administrative Region, China
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX, UK
| |
Collapse
|
16
|
Danielli S, Ashrafian H, Darzi A. Healthy city: global systematic scoping review of city initiatives to improve health with policy recommendations. BMC Public Health 2023; 23:1277. [PMID: 37393224 PMCID: PMC10314468 DOI: 10.1186/s12889-023-15908-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 05/12/2023] [Indexed: 07/03/2023] Open
Abstract
BACKGROUND Global health will increasingly be determined by cities. Currently over half of the world's population, over 4 billion people, live in cities. This systematic scoping review has been conducted to understand what cities are doing to improve health and healthcare for their populations. METHODS We conducted a systematic search to identify literature on city-wide initiatives to improve health. The study was conducted in accordance with PRISMA and the protocol was registered with PROSPERO (CRD42020166210). RESULTS The search identified 42,137 original citations, yielding 1,614 papers across 227 cities meeting the inclusion criteria. The results show that the majority of initiatives were targeted at non-communicable diseases. City health departments are making an increasing contribution; however the role of mayors appears to be limited. CONCLUSION The collective body of evidence identified in this review, built up over the last 130 years, has hitherto been poorly documented and characterised. Cities are a meta-system with population health dictated by multiple interactions and multidirectional feedback loops. Improving health in cities requires multiple actions, by multiple actors, at every level. The authors use the term 'The Vital 5'. They are the five most important health risk factors; tobacco use; harmful alcohol use; physical-inactivity, unhealthy diet and planetary health. These 'Vital 5' are most concentrated in deprived areas and show the greatest increase in low and middle income countries. Every city should develop a comprehensive strategy and action plan to address these 'Vital 5'.
Collapse
Affiliation(s)
- Shaun Danielli
- Kings Health Partners, Guys Hospital, London, SE1 9RT, UK.
- Imperial College London, South Kensington Campus, London, SW7 2NA, UK.
| | - Hutan Ashrafian
- Imperial College London, South Kensington Campus, London, SW7 2NA, UK
| | - Ara Darzi
- Imperial College London, South Kensington Campus, London, SW7 2NA, UK
| |
Collapse
|
17
|
McCoy BM, Brassington L, Jin K, Dolby GA, Shrager S, Collins D, Dunbar M, Ruple A, Snyder-Mackler N. Social determinants of health and disease in companion dogs: a cohort study from the Dog Aging Project. Evol Med Public Health 2023; 11:187-201. [PMID: 37388194 PMCID: PMC10306367 DOI: 10.1093/emph/eoad011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 03/03/2023] [Indexed: 07/01/2023] Open
Abstract
Exposure to social environmental adversity is associated with health and survival across many social species, including humans. However, little is known about how these health and mortality effects vary across the lifespan and may be differentially impacted by various components of the environment. Here, we leveraged a relatively new and powerful model for human aging, the companion dog, to investigate which components of the social environment are associated with dog health and how these associations vary across the lifespan. We drew on comprehensive survey data collected on 21,410 dogs from the Dog Aging Project and identified five factors that together explained 33.7% of the variation in a dog's social environment. Factors capturing financial and household adversity were associated with poorer health and lower physical mobility in companion dogs, while factors that captured social support, such as living with other dogs, were associated with better health when controlling for dog age and weight. Notably, the effects of each environmental component were not equal: the effect of social support was 5× stronger than financial factors. The strength of these associations depended on the age of the dog, including a stronger relationship between the owner's age and the dog's health in younger as compared to older dogs. Taken together, these findings suggest the importance of income, stability and owner's age on owner-reported health outcomes in companion dogs and point to potential behavioral and/or environmental modifiers that can be used to promote healthy aging across species.
Collapse
Affiliation(s)
| | | | - Kelly Jin
- Allen Institute for Brain Science, Seattle, WA, USA
| | - Greer A Dolby
- Department of Biology, University of Alabama at Birmingham, Birmingham, ALUSA
| | - Sandi Shrager
- Collaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Devin Collins
- Department of Sociology, University of Washington, Seattle, WA, USA
| | - Matthew Dunbar
- Center for Studies in Demography & Ecology, University of Washington, Seattle, WA, USA
| | - Dog Aging Project Consortium
AkeyJoshua MLewis-Sigler Institute for Integrative Genomics, Princeton University, Princeton, NJ, USABentonBrookeDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USABorensteinElhananDepartment of Clinical Microbiology and Immunology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, IsraelCastelhanoMarta GCornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, NY, USAColemanAmanda EDepartment of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA, USACreevyKate EDepartment of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USACrowderKyleDepartment of Sociology, University of Washington, Seattle, WA, USADunbarMatthew DCenter for Studies in Demography and Ecology, University of Washington, Seattle, WA, USAFajtVirginia RDepartment of Veterinary Physiology and Pharmacology, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USAFitzpatrickAnnette LDepartment of Family Medicine, University of Washington, Seattle, WA, USAJefferyUnityDepartment of Veterinary Pathobiology, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USAJonlinErica CDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USAKaeberleinMattDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USAKarlssonElinor KBioinformatics and Integrative Biology, University of Massachusetts Chan Medical School, Worcester, MA, USAKerrKathleen FDepartment of Biostatistics, University of Washington, Seattle, WA, USALevineJonathan MDepartment of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USAMaJingDivision of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USAMcClellandRobyn LDepartment of Biostatistics, University of Washington, Seattle, WA, USAPromislowDaniel E LDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USARupleAudreyDepartment of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USASchwartzStephen MEpidemiology Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USAShragerSandiCollaborative Health Studies Coordinating Center, Department of Biostatistics, University of Washington, Seattle, WA, USASnyder-MacklerNoahSchool of Life Sciences, Arizona State University, Tempe, AZ, USATolbertKatherineDepartment of Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine & Biomedical Sciences, College Station, TX, USAUrferSilvan RDepartment of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, USAWilfondBenjamin STreuman Katz Center for Pediatric Bioethics, Seattle Children’s Research Institute, Seattle, WA, USA
| | - Audrey Ruple
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA, USA
| | - Noah Snyder-Mackler
- Corresponding author. School of Life Sciences, Arizona State University, Tempe, AZ, USA. E-mail:
| |
Collapse
|
18
|
Ghammari F, Jalilian H, Khodayari‐zarnaq R, Gholizadeh M. Health care utilization and its association with sociodemographic factors among slum-dwellers with type 2 diabetes in Tabriz, Iran: A cross-sectional study. Health Sci Rep 2023; 6:e1272. [PMID: 37251526 PMCID: PMC10213483 DOI: 10.1002/hsr2.1272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 04/18/2023] [Accepted: 05/03/2023] [Indexed: 05/31/2023] Open
Abstract
Background and Aims Slums are known as growing underprivileged areas. One of the health adverse effects of slum-dwelling is health care underutilization. Management of type 2 diabetes mellitus (T2DM) requires an appropriate utilization. This study aimed to investigate the extent of health care utilization among slum-dwellers with T2DM in Tabriz, Iran, in 2022. Methods We conducted a cross-sectional study on 400 patients with T2DM living in slum areas of Tabriz, Iran. Sampling was conducted using a systematic random sampling method. A researcher-made questionnaire was used for data collection. To develop the questionnaire, we used Iran's Package of Essential Noncommunicable (IraPEN) diseases, in which potential needs and essential health care for patients with diabetes and the appropriate time intervals for use are specified. Data were analyzed using SPSS version 22. Results Although 49.8% of patients needed outpatient services, only 38.3% were referred to health centers and utilized health services. The results of the binary logistic regression model showed that women (OR = 1.871, CI 1.170-2.993), those with higher income levels (OR = 1.984, CI 1.105-3.562), and those with diabetes complications (Adjusted OR = 1.7, CI 0.2-0.603) were almost 1.8 times more likely to utilize outpatient services. Additionally, those with diabetes complications (OR = 1.93, CI 0.189-2.031) and those taking oral medication (OR = 3.131, CI 1.825-5.369) were respectively 1.9 and 3.1 times more likely to utilize inpatient care services. Conclusions Our study showed that, although slum-dwellers with type 2 diabetes needed outpatient services, a small percentage were referred to health centers and utilized health services. Multispectral cooperation is necessary for improving the status quo. There is a need to take appropriate interventions to strengthen health care utilization among residents with T2DM living in slum sites. Also, insurance organizations should cover more health expenditures and provide a more comprehensive benefits package for these patients.
Collapse
Affiliation(s)
- Fawzieh Ghammari
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Habib Jalilian
- Department of Health Services Management, School of HealthAhvaz Jundishapur University of Medical SciencesAhvazIran
| | - Rahim Khodayari‐zarnaq
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| | - Masumeh Gholizadeh
- Department of Health Policy and Management, School of Management and Medical InformaticsTabriz University of Medical SciencesTabrizIran
| |
Collapse
|
19
|
Röhrbein H, Hilger-Kolb J, Heinrich K, Kairies H, Hoffmann K. An Iterative, Participatory Approach to Developing a Neighborhood-Level Indicator System of Health and Wellbeing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1456. [PMID: 36674211 PMCID: PMC9859574 DOI: 10.3390/ijerph20021456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/17/2023]
Abstract
Despite increased awareness of the essential role of neighborhood characteristics for residents' health and wellbeing, the development of neighborhood-level indicator systems has received relatively little attention to date. To address this gap, we describe the participatory development process of a small-area indicator system that includes information on local health needs in a pilot neighborhood in the German city of Mannheim. To identify relevant indicators, we partnered with representatives of the city's public health department and used an iterative approach that included multiple Plan-Do-Check-Act cycles with ongoing feedback from local key stakeholders. The described process resulted in a web-based indicator system with a total of 86 indicators. Additionally, 123 indicators were perceived as relevant by stakeholders but could not be included due to data unavailability. Overall, stakeholders evaluated the participatory approach as useful. Even though the onset of the COVID-19 pandemic and the lack of some data elements hindered instrument development, close collaboration with public health partners facilitated the process. To identify and target sub-national health inequalities, we encourage local public health stakeholders to develop meaningful and useful neighborhood-level indicator systems, building on our experiences from the applied development process and considering identified barriers and facilitators.
Collapse
Affiliation(s)
- Hannah Röhrbein
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Jennifer Hilger-Kolb
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| | - Kathrin Heinrich
- Youth Welfare Office and Public Health Department, Division for Youth Welfare Planning and Public Health Planning, 68161 Mannheim, Germany
| | - Holger Kairies
- Youth Welfare Office and Public Health Department, Division for Youth Welfare Planning and Public Health Planning, 68161 Mannheim, Germany
| | - Kristina Hoffmann
- Center for Preventive Medicine and Digital Health (CPD), Medical Faculty Mannheim, Heidelberg University, 68167 Mannheim, Germany
| |
Collapse
|
20
|
Zhang Z, Zhao M, Zhang Y, Feng Y. How does urbanization affect public health? New evidence from 175 countries worldwide. Front Public Health 2023; 10:1096964. [PMID: 36684862 PMCID: PMC9852986 DOI: 10.3389/fpubh.2022.1096964] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 12/15/2022] [Indexed: 01/07/2023] Open
Abstract
Urbanization is an essential indicator of contemporary society and a necessary historic stage in the industrialization of all countries. Thus, we explore the impact of urbanization on public health using the OLS estimation and a two-way fixed effect model based on annual panel data from 175 countries from 2000 to 2018. This paper also addresses potential endogeneity issues and identifies causal relationships using the coefficient stability tests, system GMM, and instrumental variable method. The results demonstrate that urbanization positively affects public health. Furthermore, we find that the impact of urbanization on public health can be mediated through living standards, and nations with higher living standards reduce the effect of urbanization on public health. An increase in the urbanization rate can promote public health by improving residents' living standards. Our results have significant real-world implications for the research of urbanization and the formulation of public health policy.
Collapse
Affiliation(s)
- Zhenhua Zhang
- Institute of Green Finance, Lanzhou University, Lanzhou, China
| | - Mingcheng Zhao
- School of Management, Lanzhou University, Lanzhou, China
| | - Yunpeng Zhang
- School of Management, Lanzhou University, Lanzhou, China
| | - Yanchao Feng
- Business School, Zhengzhou University, Zhengzhou, China,*Correspondence: Yanchao Feng ✉
| |
Collapse
|
21
|
Porcherie M, Thomas MF, Quidu F, Héritage Z, Vaillant Z, Simos J, Rican S, Cantoreggi N, Faure E, Gall ARL. How to Evaluate Health in All Policies at the Local Level: Methodological Insights Within Municipalities From the WHO French Healthy Cities Network. Int J Health Policy Manag 2022; 11:3060-3070. [PMID: 35942970 PMCID: PMC10105196 DOI: 10.34172/ijhpm.2022.6584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 06/15/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND This article proposes a method for analysing the degree of maturity of Health in All Policies (HiAP) among World Health Organization-French Healthy Cities Network (WHO-FHCN) as part of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project. We focused on the creation or enhancement of health-promoting environments, and more specifically, public green spaces. METHODS We conducted a cross-sectional quantitative study guided by the evaluative framework of the HiAP maturity level developed by Storm et al mixed with a qualitative interpretation. A self-administered questionnaire was sent to elected officials and health department officers in the 85 member cities of the WHO-FHCN in 2017. Subsequently 58 cities were included in the analysis, which was based on a multiple correspondence analysis (MCA) and a hierarchical ascending classification (HAC). RESULTS Thirty-two criteria among a total of 100 were identified and were used to organize the cities into 8 groups which was then reduced to three profiles among the cities: a less advanced HiAP profile, an established HiAP profile and an advanced HiAP profile. This process allows us to identify 4 dimensions that make it possible to evaluate the level of maturity of cities in the HiAP process, namely: (1) the consideration of social inequalities in health and/or health issues in the policies/actions of the sector studied, (2) occasional intersectoral collaboration, ie, one-off initiatives between the health department and others sectors, (3) the existence of joint projects, ie, common projects between two or more sectors, (4) the existence of intersectoral bodies, in this case on the theme of urban green spaces including an intersectoral committee and/or working groups. CONCLUSION Four dimensions which allow to the measurement of the degree of progress in implementing health-all-policies are proposed. With a view to integrating knowledge into public action, this study carried out under real conditions offers a realistic method to evaluate HiAP.
Collapse
Affiliation(s)
- Marion Porcherie
- Department of Social Sciences, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France
| | - Marie-Florence Thomas
- Ecole des Hautes Etudes en Santé Publique, Leres, Irset UMR- Inserm S 1085, Rennes, France
| | - Frédérique Quidu
- Department of Social Sciences, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France
| | - Zoé Héritage
- Santé Publique France, Saint-Maurice, Paris, France
| | - Zoé Vaillant
- LADYSS, Université Paris-Nanterre, Nanterre, France
| | - Jean Simos
- Institut de Santé Globale, Université de Genève, Genève, Switzerland
| | | | - Nicola Cantoreggi
- Institut de Santé Globale, Université de Genève, Genève, Switzerland
| | | | - Anne Roué Le Gall
- Department of Health and Environment, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France
| |
Collapse
|
22
|
Zhang Z, Amegbor PM, Sigsgaard T, Sabel CE. Assessing the association between urban features and human physiological stress response using wearable sensors in different urban contexts. Health Place 2022; 78:102924. [DOI: 10.1016/j.healthplace.2022.102924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/05/2022]
|
23
|
Fazeli Dehkordi ZS, Khatami SM, Ranjbar E. The Associations Between Urban Form and Major Non-communicable Diseases: a Systematic Review. J Urban Health 2022; 99:941-958. [PMID: 35776285 PMCID: PMC9561495 DOI: 10.1007/s11524-022-00652-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 10/17/2022]
Abstract
In the current century, non-communicable diseases (NCDs), particularly cardiovascular diseases, diabetes, cancer, and chronic respiratory diseases, are the most important cause of mortality all over the world. Given the effect of the built environment on people's health, the present study seeks to conduct a systematic review in order to investigate the relationship between urban form and these four major NCDs as well as their main risk factors. Two independent reviewers in November 2020 after an extensive search through PubMed and Scopus identified 77 studies. Studies published in English were included if they addressed one or more attributes of urban form in relation to any major NCDs and their main risk factors. Publication date, country, geographical scale, study design, methods of built environment measurement, and findings of the relationships among variables were extracted from eligible studies. The findings suggest that the elements of urban form (density, transportation and accessibility, characteristics of building and streetscape, land use, spatial layouts and configuration) could increase or inhibit these diseases through their effect on physical activity, diet, air pollution, blood pressure, and obesity. However, there are study shortages, contradictions, and ambiguities in these relationships which are mainly due to methodological and conceptual challenges. As a result, more in-depth research is needed to achieve solid and consistent results that could be made into clear guidelines for planning and designing healthier cities.
Collapse
Affiliation(s)
| | - Seyed Mahdi Khatami
- Department of Urban Design & Planning, Tarbiat Modares University, Tehran, Iran
| | - Ehsan Ranjbar
- Department of Urban Design & Planning, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
24
|
Omidiji J, Samuel U, Busa F, Ayeni A. Investigating the impacts of COVID-19 safety measures and related uncertainties among socially vulnerable groups in Lagos megacity. Heliyon 2022; 8:e10090. [PMID: 36033275 PMCID: PMC9391079 DOI: 10.1016/j.heliyon.2022.e10090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 07/15/2022] [Accepted: 07/21/2022] [Indexed: 11/30/2022] Open
Abstract
The emergence of the unique coronavirus disease (COVID-19), associated safety measures and impacts have been experienced differently across various sociodemographic and livelihood groups. As a result of the impacts of the COVID-19 restrictions, this study examined experiences and livelihood uncertainties from socially vulnerable groups. One hundred and fifty responses (150) were recorded from residents in Iwaya, and Makoko areas within Lagos Mainland Local Government Area of Lagos state. Complete lockdown or stay-at-home orders, compulsory face masks in public spaces, curfews, physical and social distancing and restriction of inter-state movements are some of the precautionary/safety measures introduced by the Government and enforced by security agents. The findings show that curfews and restriction of inter-state movements were two of the safety measures that had no or reduced impact (p-values > 0.01) on the respondents’ means of livelihood. Our results reveal that because a larger percentage of male participants are self-employed and owned personal businesses they were more affected by COVID-19 restrictions than females. 42.7% (64) of females and 57.3% (86) of males reported COVID-19-related anxieties and stress from fear of starvation, and contracting the virus, to impacts on money/finances, slow sales and businesses, food supply, job loss, erratic power supply affecting work from home options. 54.7% of respondents had more than 5 people living together, while 84.7% of housing types (128) are bungalows with several rooms inhabited by an average of three to four people per household. Increased stress, fear of hunger, loss of jobs and source of income were some of the negative impacts resulting from the introduction of the COVID-19 safety measures which adversely affected occupations like traders, people engaged in fishing activities, painters, carpenters, hairdressers and barbers, printers and bricklayers. Our work provides insights into the effects of the COVID-19-safety measures and subjective impact across vulnerable groups and occupations.
Collapse
Affiliation(s)
- Jokotola Omidiji
- Geography Department, University of Lagos, Akoka, Lagos, Nigeria
| | - Udofia Samuel
- Geography Department, University of Lagos, Akoka, Lagos, Nigeria
| | - Fashoto Busa
- Geography Department, University of Lagos, Akoka, Lagos, Nigeria
| | - Amidu Ayeni
- Geography Department, University of Lagos, Akoka, Lagos, Nigeria
| |
Collapse
|
25
|
Payán DD, Lewis LB, Illum J, Hawkins B, Sloane DC. United for health to improve urban food environments across five underserved communities: a cross-sector coalition approach. BMC Public Health 2022; 22:888. [PMID: 35509034 PMCID: PMC9066811 DOI: 10.1186/s12889-022-13245-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 04/18/2022] [Indexed: 11/28/2022] Open
Abstract
Background Cross-sector coalitions can be a powerful vehicle to promote adoption and implementation of evidence-based programs and policies across diverse racial/ethnic communities with a high chronic disease burden. Few studies have examined coalition composition, function, or capacity to promote learning among members. Methods We used a mixed methods approach to examine the United for Health coalition’s implementation of multiple food environment interventions across five low-income communities of color in Los Angeles, California (USA). At the coalition-level, key measures included the collaborative environment, membership characteristics, process and structure, communication, resources, strengths, challenges/barriers, and community impact. At the organizational- and individual-levels, we collected data on participation, leadership development, intraorganizational change, perceived benefits, and learning outcomes. Findings Overall, the United for Health coalition produced five community gardens, three pop-up produce markets, and one farmers’ market; members also expanded Electronic Benefits Transfer (EBT) access at three existing farmers’ markets. Findings indicate early coalition strengths included having a mutual purpose, which was maintained throughout the study period. Coalition participation and engagement was consistently high, while coalition and inter-organizational communication improved over time. Strengths were membership diversity and the availability of learning opportunities. Benefits included leadership development and strategic alignment across organizations. Members demonstrated an increased awareness of the importance of culturally adapted interventions and knowledge of community health planning topics. Key implementation challenges were a lack of resources and social context barriers. Conclusions Examining coalition function and maturation in a real-world context reveals important lessons for scholars and practitioners committed to addressing nutrition-related health disparities in marginalized and historically underserved communities. Future work should investigate the sustainability of externally funded cross-sector coalitions after funding ceases. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13245-2.
Collapse
Affiliation(s)
- Denise D Payán
- Department of Health, Society, and Behavior, University of California Irvine, Irvine, CA, 92697, USA.
| | - LaVonna B Lewis
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| | - Jacqueline Illum
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| | - Breanna Hawkins
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| | - David C Sloane
- Sol Price School of Public Policy, University of Southern California (USC), Los Angeles, CA, 90015, USA
| |
Collapse
|
26
|
Selected Research Issues of Urban Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095553. [PMID: 35564947 PMCID: PMC9105718 DOI: 10.3390/ijerph19095553] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 01/17/2023]
Abstract
Health is created within the urban settings of people’s everyday lives. In this paper we define Urban Public Health and compile existing evidence regarding the spatial component of health and disease in urban environments. Although there is already a substantial body of single evidence on the links between urban environments and human health, focus is mostly on individual health behaviors. We look at Urban Public Health through a structural lens that addresses health conditions beyond individual health behaviors and identify not only health risks but also health resources associated with urban structures. Based on existing conceptual frameworks, we structured evidence in the following categories: (i) build and natural environment, (ii) social environment, (iii) governance and urban development. We focused our search to review articles and reviews of reviews for each of the keywords via database PubMed, Cochrane, and Google Scholar in order to cover the range of issues in urban environments. Our results show that linking findings from different disciplines and developing spatial thinking can overcome existing single evidence and make other correlations visible. Further research should use interdisciplinary approaches and focus on health resources and the transformation of urban structures rather than merely on health risks and behavior.
Collapse
|
27
|
Green in times of COVID-19: urban green space relevance during the COVID-19 pandemic in Buenos Aires City. Urban Ecosyst 2022; 25:941-953. [PMID: 35095260 PMCID: PMC8790949 DOI: 10.1007/s11252-022-01204-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2022] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic has had a deep impact on the way we perceive our world. This study explores its effect on Urban Green Space (UGS) perception in Buenos Aires City (CABA), Argentina. We provide a detailed overview of the distribution of UGS in CABA, along with socio-economic analysis and visitors' profile and perception before and during the restrictive measures adopted by the national authorities to contain the COVID-19 outbreak (July to December of 2020). We conducted a series of surveys based on open and closed questions. Before the pandemic, surveys were carried out in situ in eight parks of six districts, randomly chosen. During the confinement, online surveys were conducted. According to our results, the mean UGS density in CABA is 6.09 m2 /person, but marked differences between districts exist, ranging from 0.02 m2 /person to 17.68 m2 /person. This uneven distribution causes differences in the quality of life of CABA inhabitants, perhaps more pronounced during reduced-mobility situations like COVID-19 confinement. Socio economic analysis were done linking multidimensional poverty, COVID-19 positive cases and urban mobility in CABA. Regarding UGS visitors, before the confinement, the majority of respondents were employees or students; during the confinement, employees and retirees predominated. When asked to choose important attributes to describe their perception about the UGS from a given list, respondents selected “calm,” “green,” and “sounds of nature,” without differences before and during the confinement. However, when asked about the UGS role, the main answer was “a place to be with nature” before the confinement and “an important place in the city” during it. Understanding how society perceives the UGS, especially during crises, is essential to rethink the urban landscape and prepare our cities, towards biophilic cities and for a more sustainable future.
Collapse
|
28
|
Phulkerd S, Rachmi CN, Sameeha MJ, Borazon EQ, Thow AM, Trevena H, Saptari AF, Cheah YK, Wel CAC, Marquez VT, Sakulsri T, Thongcharoenchupong N, Poh BK. Identifying Opportunities for Strategic Policy Design to Address the Double Burden of Malnutrition through Healthier Retail Food: Protocol for South East Asia Obesogenic Food Environment (SEAOFE) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:528. [PMID: 35010789 PMCID: PMC8744775 DOI: 10.3390/ijerph19010528] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/20/2021] [Accepted: 12/22/2021] [Indexed: 01/27/2023]
Abstract
Effective policies that address both the supply and demand dimensions of access to affordable, healthy foods are required for tackling malnutrition in South East Asia. This paper presents the Protocol for the South East Asia Obesogenic Food Environment (SEAOFE) study, which is designed to analyze the retail food environment, consumers' and retailers' perspectives regarding the retail food environment, and existing policies influencing food retail in four countries in South East Asia in order to develop evidence-informed policy recommendations. This study was designed as a mixed-methods sequential explanatory approach. The country sites are Malaysia, Indonesia, the Philippines, and Thailand. The proposed study consists of four phases. Phase One describes the characteristics of the current retail food environment using literature and data review. Phase Two interprets consumer experience in the retail food environment in selected urban poor communities using a consumer-intercept survey. This phase also assesses the retail food environment by adapting an in-store audit tool previously validated in higher-income countries. Phase Three identifies factors influencing food retailer decisions, perceptions, and attitudes toward food retail policies using semi-structured interviews with selected retailers. Phase Four recommends changes in the retail food environment using policy analysis and semi-structured interviews with key stakeholders. For the analysis of the quantitative data, descriptive statistics and multiple regression will be used, and thematic analysis will be used to process the qualitative data. This study will engage stakeholders throughout the research process to ensure that the design and methods used are sensitive to the local context.
Collapse
Affiliation(s)
- Sirinya Phulkerd
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; (S.P.); (T.S.); (N.T.)
| | | | - Mohd Jamil Sameeha
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| | - Elaine Q. Borazon
- International Graduate Program of Education and Human Development (IGPEHD), College of Social Sciences, National Sun Yat-Sen University, Kaohsiung City 80424, Taiwan;
| | - Anne-Marie Thow
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney 2006, Australia; (A.-M.T.); (H.T.)
| | - Helen Trevena
- Menzies Centre for Health Policy and Economics, University of Sydney, Sydney 2006, Australia; (A.-M.T.); (H.T.)
| | | | - Yong Kang Cheah
- School of Economics, Finance and Banking, Universiti Utara Malaysia, Sintok 06010, Malaysia;
| | - Che Aniza Che Wel
- Faculty of Economics and Management, Universiti Kebangsaan Malaysia (UKM), Bangi 43600, Malaysia;
| | - Vanessa T. Marquez
- School of Economics, University of the Philippines-Diliman, Quezon City 1101, Philippines;
| | - Teeranong Sakulsri
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; (S.P.); (T.S.); (N.T.)
| | - Natjera Thongcharoenchupong
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom 73170, Thailand; (S.P.); (T.S.); (N.T.)
| | - Bee Koon Poh
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia;
| |
Collapse
|
29
|
Hernández Flórez LJ, Rios-Oliveros DS. La atención primaria en salud renovada: el caso de Bogotá en un escenario de pandemia de COVID-19. Rev Salud Publica (Bogota) 2022. [DOI: 10.15446/rsap.v24n1.103277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
La atención primaria en salud es la estrategia central definida por la organización Panamericana de la Salud (OPS) para alcanzar el objetivo de “Salud Para Todos” propuesto desde 1978 por Alma Ata. En la región de las américas esta estrategia ha sido incluida dentro de los sistemas de salud y se ha interpretado y adaptado a los contextos políticos, culturales, sociales y económicos de los países en vía de desarrollo. En Colombia esta propuesta ha estado inmersa y algunas normas la definen y acotan para el desarrollo en los municipios. Bogotá ha incluido esta propuesta desde hace ya varios años, y en cada cambio de gobierno se le da una connotación particular acorde con las propuestas de los planes territoriales de salud y las propuestas en los planes de desarrollo, con mayor o menor énfasis en sus postulados. Este artículo muestra el abordaje que se da desde la atención primaria en los últimos periodos de gobierno y cómo interactúa en una pandemia como la de COVID-19.
Collapse
|
30
|
Ayubcha C, Pouladvand P, Ayubcha S. A Quasi-Experimental Study of Medicaid Expansion and Urban Mortality in the American Northeast. Front Public Health 2021; 9:707907. [PMID: 34869142 PMCID: PMC8637894 DOI: 10.3389/fpubh.2021.707907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/08/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: To investigate the association of state-level Medicaid expansion and non-elderly mortality rates from 1999 to 2018 in Northeastern urban settings. Methods: This quasi-experimental study utilized a synthetic control method to assess the association of Medicaid expansion on non-elderly urban mortality rates [1999–2018]. Counties encompassing the largest cities in the Northeastern Megalopolis (Washington D.C., Baltimore, Philadelphia, New York City, and Boston) were selected as treatment units (n = 5 cities, 3,543,302 individuals in 2018). Cities in states without Medicaid expansion were utilized as control units (n = 17 cities, 12,713,768 individuals in 2018). Results: Across all cities, there was a significant reduction in the neoplasm (Population-Adjusted Average Treatment Effect = −1.37 [95% CI −2.73, −0.42]) and all-cause (Population-Adjusted Average Treatment Effect = −2.57 [95%CI −8.46, −0.58]) mortality rate. Washington D.C. encountered the largest reductions in mortality (Average Treatment Effect on All-Cause Medical Mortality = −5.40 monthly deaths per 100,000 individuals [95% CI −12.50, −3.34], −18.84% [95% CI −43.64%, −11.67%] reduction, p = < 0.001; Average Treatment Effect on Neoplasm Mortality = −1.95 monthly deaths per 100,000 individuals [95% CI −3.04, −0.98], −21.88% [95% CI −34.10%, −10.99%] reduction, p = 0.002). Reductions in all-cause medical mortality and neoplasm mortality rates were similarly observed in other cities. Conclusion: Significant reductions in urban mortality rates were associated with Medicaid expansion. Our study suggests that Medicaid expansion saved lives in the observed urban settings.
Collapse
Affiliation(s)
| | - Pedram Pouladvand
- Alfred I. DuPont Hospital for Children, Wilmington, NC, United States
| | - Soussan Ayubcha
- Marcus Institute of Integrative Health, Thomas Jefferson University, Philadelphia, PA, United States
| |
Collapse
|
31
|
Kim I. Spatial distribution of neighborhood-level housing prices and its association with all-cause mortality in Seoul, Korea (2013-2018): A spatial panel data analysis. SSM Popul Health 2021; 16:100963. [PMID: 34820502 PMCID: PMC8599165 DOI: 10.1016/j.ssmph.2021.100963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/27/2021] [Accepted: 11/09/2021] [Indexed: 11/29/2022] Open
Abstract
Housing prices are known to be a relevant indicator of the socioeconomic position of the neighborhood. In a society where the market system mainly drives housing prices, residents' spatial patterning is formulated according to their socioeconomic position. Dividing the 2013-2018 entire study period into three periods, we explored the spatial distribution of housing prices and all-cause mortality and their association in Seoul, the country's capital city. The government authorities' data and 2015 census data were used for the study. We mapped the spatial distribution of housing prices and all-cause mortality and investigated the changes in distribution. We conducted a pooled ordinary least square (OLS) and spatial panel regression analysis to estimate housing prices elasticity of all-cause mortality. We also explored the possible mediating role of housing prices on the educational composition's effect on all-cause mortality. We found the common trends of increasing spatial patterning of housing prices and all-cause mortality. The magnitude of spatial patterning was far greater in housing prices than all-cause mortality. A pooled OLS regression analysis found that a 1% increase in housing price was associated with a 0.11% reduction in all-cause mortality after controlling the explanatory variables. Attenuation in the regression coefficient's magnitude was found after adding the neighborhood's educational composition to the model. As a result of spatial panel analysis, we found a direction and scale similar to the housing price elasticity of all-cause mortality in the final pooled OLS model. The results suggested that spatial health inequality in Korea's urban space mainly stems from socioeconomic inequality.
Collapse
Affiliation(s)
- Ikhan Kim
- Department of Medical Humanities and Social Medicine, Kosin University College of Medicine, 262 Gamcheon-ro, Seo-gu, Busan, 49267, South Korea
| |
Collapse
|
32
|
Tetui M, Ssekamatte T, Akilimali P, Sirike J, Fonseca-Rodríguez O, Atuyambe L, Makumbi FE. Geospatial Distribution of Family Planning Services in Kira Municipality, Wakiso District, Uganda. Front Glob Womens Health 2021; 1:599774. [PMID: 34816171 PMCID: PMC8593998 DOI: 10.3389/fgwh.2020.599774] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Access to family planning (FP) services remains a challenge, particularly in informal urban settlements. The unmet need for FP in these settings is high, with a correspondingly high prevalence of unintended pregnancies that may lead to unsafe abortions. However, there is a paucity of quality data on the distribution of FP services in such settings in Uganda. This paper described the geospatial distribution of FP services in Kira Municipality, Wakiso District, Uganda. Methods: This was a cross-sectional study in which we determined the availability and distribution of FP services in Kira Municipality. Community mapping and analysis were conducted using ArcGIS (version 10.1) and ArcGIS Online. Stata version 13.1 was used for data analysis. Chi-square test was used to compare the contraceptive provision and availability among facilities from informal and formal settlements. Results: Of the 176 healthcare facilities surveyed, only 42% (n = 74) offered contraceptives in informal settlements. The majority of the facilities were privately owned small clinics (95%). At least 80% of the facilities provided three or more modern contraceptive methods, with no difference (p = 0.107) between facilities in informal and formal settlements. Only 30.7% (p = 0.001) of the facilities provided at least one long-acting contraceptive. Similarly, 20 and 12% (p = 0.001) of the facilities had implants and intrauterine devices (IUDs) on the day of the survey. Almost 25% of the facilities did not offer contraceptive services (counseling and commodities) to unmarried adolescents. Conclusions: Most facilities were small privately-owned clinics, offering at least three modern contraceptive methods. The unavailability of long-acting reversible methods in the informal settings may affect the quality of FP services due to limited choice. The inequity in service provision that disfavors the unmarried adolescent may increase unwanted/unintended pregnancies. We recommend that local governments and partners work toward filling the existing commodities gap and addressing the discrimination against unmarried adolescents in such settings.
Collapse
Affiliation(s)
- Moses Tetui
- School of Pharmacy, Waterloo University, Waterloo, ON, Canada.,Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Department of Health Policy, Planning and Management, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Tonny Ssekamatte
- Department of Disease Control and Environmental Health, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Pierre Akilimali
- Department of Nutrition Kinshasa School of Public Health, Faculty of Medicine, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - Judith Sirike
- Division of Social Development, Intergovernmental Authority on Development, Kampala, Uganda
| | - Osvaldo Fonseca-Rodríguez
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.,Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - Lynn Atuyambe
- Department of Community Health and Behavioural Sciences, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| | - Fredrick Edward Makumbi
- Department of Epidemiology and Biostatistics, Makerere University School of Public Health, New Mulago Hospital Complex, Kampala, Uganda
| |
Collapse
|
33
|
Yu D, Li X, Yu J, Shi X, Liu P, Tian P. Whether Urbanization Has Intensified the Spread of Infectious Diseases-Renewed Question by the COVID-19 Pandemic. Front Public Health 2021; 9:699710. [PMID: 34900884 PMCID: PMC8652246 DOI: 10.3389/fpubh.2021.699710] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 10/05/2021] [Indexed: 12/30/2022] Open
Abstract
The outbreak of the COVID-19 epidemic has triggered adiscussion of the relationship between urbanization and the spread of infectious diseases. Namely, whether urbanization will exacerbate the spread of infectious diseases. Based on 31 provincial data from 2002 to 2018 in China, the impact of urbanization on the spread of infectious diseases from the dimensions of "population" and "land" is analyzed in this paper by using the GMM (generalized method of moments) model. The empirical study shows that the population increase brought by urbanization does not aggravate the spread of infectious diseases. On the contrary, urban education, employment and entrepreneurship, housing, medical and health care, and other basic public services brought by population urbanization can help reduce the risk of the spread of infectious diseases. The increasing density of buildings caused by land urbanization increases the risk of the spread of infectious diseases. Moreover, the impact of urbanization on the spread of infectious diseases has regional heterogeneity. Therefore, the prevention and control of disease play a crucial role.
Collapse
Affiliation(s)
- Dongsheng Yu
- School of Economics, Zhongnan University of Economics and Law, Wuhan, China
| | - Xiaoping Li
- School of Economics, Zhongnan University of Economics and Law, Wuhan, China
| | - Juanjuan Yu
- School of Economics, Zhongnan University of Economics and Law, Wuhan, China
| | - Xunpeng Shi
- Australia-China Relations Institute, University of Technology Sydney, Sydney, NSW, Australia
| | - Pei Liu
- School of Economics, Zhengzhou University of Aeronautics, Zhengzhou, China
| | - Pu Tian
- School of Economics, Zhongnan University of Economics and Law, Wuhan, China
| |
Collapse
|
34
|
Kane N. Revealing the racial and spatial disparity in pediatric asthma: A Kansas City case study. Soc Sci Med 2021; 292:114543. [PMID: 34802780 DOI: 10.1016/j.socscimed.2021.114543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 07/22/2021] [Accepted: 11/04/2021] [Indexed: 12/24/2022]
Abstract
Black and other socially disadvantaged children are disproportionately burdened by high rates of pediatric asthma. Intraurban variation in environmental risk factors and limited access to high-resolution health data make it difficult to identify vulnerable patients, communities, or the immediate exposures that may contribute to pediatric asthma exacerbation. This article presents a novel, interdisciplinary health disparities research and intervention strategy applied to the problem of pediatric asthma in Kansas City. First, address-level electronic health records from a major children's hospital in the Kansas City region are used to map the distribution of asthma encounters in 2012 at a high spatial resolution. Census tract Environmental Justice Screening Method (EJSM) indicators are then developed to scan for patterns in both the population health risks and vulnerabilities that may contribute to the burden of asthma in different communities. A Bayesian Profile Regression cluster analysis is used to systematically explore the complex relationships between census tract EJSM indicators and pediatric asthma incidence rates, helping to identify population characteristics and risk factors associated with both high and low rates of pediatric asthma throughout the region. The EJSM scanning exercise and BPR analysis demonstrate that each community faces a distinct set of risks and vulnerabilities that can contribute to the rate of acute pediatric asthma acute care encounters, providing targets for research and intervention. It is clear, however, that different forms of social disadvantage are driving high rates of pediatric asthma, which is closely tied to uneven development patterns and racial residential segregation. The results provide a starting point for designing place-based health disparities research and intervention strategies catered to the unique needs of vulnerable patients and communities; disparities-focused research and intervention strategies that leverage local knowledge and resources through community-based practices.
Collapse
Affiliation(s)
- Natalie Kane
- Children's Mercy Hospital, Kansas City, MO, USA.
| |
Collapse
|
35
|
Whose Health in Whose City? A Systems Thinking Approach to Support and Evaluate Plans, Policies, and Strategies for Lasting Urban Health. SUSTAINABILITY 2021. [DOI: 10.3390/su132112225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
An increasing interest has been present in scientific literature and policy making for the links between urban environments and health, as also learnt from the COVID-19 pandemic. Collaboration between urban planning and public health is therefore critical for enhancing the capabilities of a city to promote the well-being of its people. However, what leverage potential for urban health can be found in existing plans, policies, and strategies that address urban health? Starting from the relationship between urban systems and health issues, the purpose of this contribution is to broaden the systemic knowledge of urban systems and health so as to try to figure out the impact potential of local urban governance on public health. Considering the systemic nature of health issues, as defined by the World Health Organisation, this is done through a systems thinking epistemological approach. Urban health proposals are studied and assessed in four European cities (Copenhagen, London, Berlin, and Vienna). Current criticalities are found, starting from the guiding goal of such proposals, yet a systemic approach is suggested aimed at supporting and evaluating lasting and healthy urban planning and management strategies.
Collapse
|
36
|
Boo YY, Rai K, Cupp MA, Lakhanpaul M, Factor-Litvak P, Parikh P, Panda R, Manikam L. What are the determinants of childhood infections in India's peri-urban slums? A case study of eight cities. PLoS One 2021; 16:e0257797. [PMID: 34653203 PMCID: PMC8519422 DOI: 10.1371/journal.pone.0257797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 09/11/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Respiratory Tract Infections (RTIs) and Gastro-Intestinal (GI) infections are the leading causes of child mortality and morbidity. This study investigates the associations between the individual, household and slum-level determinants of children's health and vulnerability to RTIs and GI infections in peri-urban slums in India; an area of research interest at the Childhood Infections and Pollution Consortium. METHODS The 2015-16 Indian National Family Health Survey was used for data analysis on children aged 0-5 years. NFHS-4 includes data on slums in eight Indian cities, including Delhi, Meerut, Kolkata, Indore, Mumbai, Nagpur, Hyderabad, Chennai. The outcome variables, having fever and cough (FeCo) and diarrhoea in the last two weeks, were used to define the phenotype of infections; for this analysis fever and cough were measures of RTIs and diarrhoea was used to measure GI infections. Exposures considered in this study include variables at the individual, household and slum level and were all informed by existing literature. Multilevel models were used to estimate the association between exposures and outcomes variables; a prior of Cauchy distribution with a scale of 2.5 was selected when building the multilevel logistic models. RESULTS The total sample size of the number of children included in the analysis was n = 1,424. Data was imputed to account for missingness, and the original and imputed sample showing similar distributions. Results showed that diarrhoea and FeCo were both found to be more present in younger children than older children by a few months. In fixed effects, the odds of developing FeCo were higher if the mother perceives the child was born smaller than average (AOR 4.41, 1.13-17.17, P<0.05) at individual level. On the other hand, the odds of the diarrhoea outcome were lower if the child was older (AOR 0.97, 0.96-0.98, P<0.05) at individual level, and household's water source was public tap or standpipe (AOR 0.54, 0.31-0.96, P<0.05) at household level. CONCLUSION The determinants of health, both social and related to health care, at all levels demonstrated linkages to child morbidity in RTIs and GI infections. The empirical evidence highlights the need for contextualised ideas at each level, including one health approach when designing interventions to improve child health.
Collapse
Affiliation(s)
- Yebeen Ysabelle Boo
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Aceso Global Health Consultants PTE Ltd., Singapore, Singapore
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
| | - Kritika Rai
- Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom
- Aceso Global Health Consultants PTE Ltd., Singapore, Singapore
| | - Meghan A. Cupp
- Aceso Global Health Consultants PTE Ltd., Singapore, Singapore
- Brown University School of Public Health, Providence, Rhode Island, United States of America
| | - Monica Lakhanpaul
- Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Whittington Health NHS Trust, London, United Kingdom
| | - Pam Factor-Litvak
- Columbia University Mailman School of Public Health, New York, New York, United States of America
| | - Priti Parikh
- Engineering for International Development Centre, Bartlett School of Construction and Project Management, Faculty of Built Environment, University College London, London, United Kingdom
| | | | - Logan Manikam
- Aceso Global Health Consultants PTE Ltd., Singapore, Singapore
- Department of Epidemiology and Public Health, University College London Institute of Epidemiology and Health Care, London, United Kingdom
| | | |
Collapse
|
37
|
Luo Y, Zhao Y, Pang L, Guo C, Liang R, Zheng X. Association Between Urbanicity and Dementia in China: A Population-Based Study. J Gerontol B Psychol Sci Soc Sci 2021; 76:1644-1651. [PMID: 32644163 DOI: 10.1093/geronb/gbaa090] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES This study investigated the relationship between urbanicity and dementia and predicted its nonlinear pattern among Chinese adults aged 50 years and older. METHODS This study used data from the Second National Sample Survey on Disability, which was implemented from April 1 to May 31, 2006 across China. Dementia status was determined by a 2-stage process: the combination of self-reports or family members' reports and an onsite medical diagnosis by experienced specialists based on the International Statistical Classification of Diseases and Related Health Problems 10th Revision Symptom Checklist for Mental Disorders. Logistic regression models were used to examine the relationship between urbanicity and dementia, and restricted polynomial spline regression models were plotted to examine the nonlinear exposure-response relationship of urbanicity and dementia. RESULTS Logistic regression results showed that an increase of 10% in the degree of urbanization was associated with a 73% decrease in the odds of dementia after adjusting for covariates, particularly area-level socioeconomic variables. This observed association was stronger in the younger age group, and this age group difference was only present in women. Spline regression findings suggested a nonlinear exposure-response relationship between urbanicity and the odds of dementia. Areas with very high levels of urbanization were associated with increased odds of dementia. CONCLUSIONS These findings highlight the necessity to properly examine the nuanced relationship between urbanicity and mental health, especially for women in the younger age group. Notably, there were increased odds of dementia at very high levels of urbanicity.
Collapse
Affiliation(s)
- Yanan Luo
- Institute of Population Research, Peking University, Beijing, China.,Advanced Systems Analysis, International Institute for Applied Systems Analysis, Laxenburg, Austria.,APEC Health Science Academy, Peking University, Beijing, China
| | - Yihao Zhao
- Institute of Population Research, Peking University, Beijing, China.,APEC Health Science Academy, Peking University, Beijing, China
| | - Lihua Pang
- Institute of Population Research, Peking University, Beijing, China.,APEC Health Science Academy, Peking University, Beijing, China
| | - Chao Guo
- Institute of Population Research, Peking University, Beijing, China.,APEC Health Science Academy, Peking University, Beijing, China
| | | | - Xiaoying Zheng
- Institute of Population Research, Peking University, Beijing, China.,APEC Health Science Academy, Peking University, Beijing, China
| |
Collapse
|
38
|
Coalition-Committees as Network Interventions: Baseline Network Composition in Context of Childhood Obesity Prevention Interventions. SYSTEMS 2021. [DOI: 10.3390/systems9030066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community coalitions can address local issues with deep, historic, and contextual understanding that enables customized implementation of evidence-based strategies. The individuals within the coalition, their partnerships, and the social context is likely an important component of unraveling the challenges of implementation so interventions reach people in need. We focus on the relevance of baseline coalition-committee network (CCN), the networks of purposely formed subcommittees within community coalitions, structure as one of the moderating, theoretical links between community coalition social networks and intervention success. We explore the baseline composition and characteristics of five CCNs at the beginning of childhood obesity prevention interventions. Using a combination of social network, multidimensional scaling, and correspondence analyses, we examine the structure and heterogeneity of five CCNs, each consisting of a core group of stakeholders in the coalition and sometimes the broader community itself. Cross-sectional analyses are used to examine the composition of coalition-committees related to network density, centralization, hierarchy, and coalition demographics and characteristics. Results indicate that CCNs are patterned in their structure and characteristics, and we discuss whether adjustments to childhood obesity prevention interventions according to baseline structure and characteristics could be advantageous for intervention implementation. Together, these findings can inform future longitudinal investigations into CCN network structure.
Collapse
|
39
|
Ng TKS, Matchar DB, Pyrkov TV, Fedichev PO, Chan AWM, Kennedy B. Association between housing type and accelerated biological aging in different sexes: moderating effects of health behaviors. Aging (Albany NY) 2021; 13:20029-20049. [PMID: 34456185 PMCID: PMC8436907 DOI: 10.18632/aging.203447] [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: 05/26/2021] [Accepted: 08/10/2021] [Indexed: 11/25/2022]
Abstract
Introduction: Despite associated with multiple geriatric disorders, whether housing type, an indicator of socioeconomic status (SES) and environmental factors, is associated with accelerated biological aging is unknown. Furthermore, although individuals with low-SES have higher body mass index (BMI) and are more likely to smoke, whether BMI and smoking status moderate the association between SES and biological aging is unclear. We examined these questions in urbanized low-SES older community-dwelling adults. Methods: First, we analyzed complete blood count data using the cox proportional hazards model and derived measures for biological age (BA) and biological age acceleration (BAA, the higher the more accelerated aging) (N = 376). Subsequently, BAA was regressed on housing type, controlling for covariates, including four other SES indicators. Interaction terms between housing type and BMI/smoking status were separately added to examine their moderating effects. Total sample and sex-stratified analyses were performed. Results: There were significant differences between men and women in housing type and BAA. Compared to residents in ≥3 room public or private housing, older adults resided in 1–2 room public housing had a higher BAA. Furthermore, BMI attenuated the association between housing type and BAA. In sex-stratified analyses, the main and interaction effects were only significant in women. In men, smoking status instead aggravated the association between housing type and BAA. Conclusion: Controlling for other SES indicators, housing type is an independent socio-environmental determinant of BA and BAA in a low-SES urbanized population. There were also sex differences in the moderating effects of health behaviors on biological aging.
Collapse
Affiliation(s)
- Ted Kheng Siang Ng
- Arizona State University, Edson College of Nursing and Health Innovation, Phoenix, AZ 85004, USA.,National Cheng Kung University, Institute of Behavioral Medicine, College of Medicine, Taiwan
| | - David Bruce Matchar
- Duke-National University of Singapore Medical School, Program in Health Services and Systems Research, Singapore.,Duke University School of Medicine, Department of Medicine (General Internal Medicine), Durham, NC 27710, USA
| | | | - Peter O Fedichev
- GERO PTE. LTD., Singapore.,Moscow Institute of Physics and Technology, Dolgoprudny, Moscow Region 141700, Russia
| | - Angelique Wei-Ming Chan
- Duke-National University of Singapore Medical School, Program in Health Services and Systems Research, Singapore.,Duke-National University of Singapore Medical School, Center for Aging, Research and Education, Singapore.,National University of Singapore, Department of Sociology, Faculty of Arts and Social Sciences, Singapore
| | - Brian Kennedy
- National University of Singapore, Center for Healthy Longevity, Healthy Longevity Program and Department of Biochemistry, Yong Loo Lin School of Medicine, Singapore.,Singapore Institute of Clinical Sciences, A*STAR, Singapore
| |
Collapse
|
40
|
Caminada S, Turatto F, Iorio S, Paglione L, Errigo M, Mazzalai E, Jaljaa A, Giannini D, Tofani M, Michelazzo MB, Landi A, Napoli M, Brandimarte MA, Salvatori LM, Angelozzi A, Baglio G, Di Rosa E, Battisti A, Marceca M. Urban Health and Social Marginality: Perceived Health Status and Interaction with Healthcare Professionals of a Hard-to-Reach Community Living in a Suburban Area of Rome (Italy). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168804. [PMID: 34444550 PMCID: PMC8394967 DOI: 10.3390/ijerph18168804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/17/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022]
Abstract
The study reports an urban health investigation conducted in Bastogi, an outskirt of Rome (Italy) characterised by social marginalization and deprivation. Our aim was to analyse the health perception, health-related behaviours, and interaction with healthcare professionals of the inhabitants of Bastogi compared to the population living in the area of the same local health unit (ASL). The Progresses of Health Authorities for Health in Italy questionnaire (PASSI) was administered to a sample of 210 inhabitants of Bastogi. Data were analysed and compared to those of the ASL collected in 2017–2018. The socio-economic indicators showed an overall worse condition for the inhabitants of Bastogi, with a significantly higher proportion of foreign and unemployed residents and a lower educational level compared to the ASL. Significant differences in the prevalence of non-communicable diseases, mental health complaints, and participation in prevention strategies, including cancer screening, were found. The questionnaire showed a lower help-seeking behaviour and a lack of reliance on health professionals in Bastogi inhabitants. Our findings highlight how social determinants produce health inequities and barriers to accessing healthcare. The difficulties of conducting quantitative research in complex and hard-to-reach contexts, characterized by high social vulnerability, are outlined.
Collapse
Affiliation(s)
- Susanna Caminada
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
- Correspondence:
| | - Federica Turatto
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Silvia Iorio
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Rome, Italy;
| | - Lorenzo Paglione
- Department of Civil, Constructional and Environmental Engineering, Sapienza University of Rome, 00184 Rome, Italy;
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | - Miriam Errigo
- Department of Social Sciences and Economics, Sapienza University of Rome, 00185 Rome, Italy;
| | - Elena Mazzalai
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Anissa Jaljaa
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Dara Giannini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Marco Tofani
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Maria Benedetta Michelazzo
- Section of Hygiene, Institute of Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Adelaide Landi
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | - Massimo Napoli
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | | | | | - Aurora Angelozzi
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| | - Giovanni Baglio
- Research and International Relations Office, Agenzia Nazionale per i Servizi Sanitari Regionali (AGENAS), 00187 Rome, Italy;
| | - Enrico Di Rosa
- Department of Prevention, Local Health Unit Roma 1, 00135 Rome, Italy; (A.L.); (M.N.); (M.A.B.); (E.D.R.)
| | - Alessandra Battisti
- Department of Planning, Design, and Technology of Architecture, Sapienza University of Rome, 00196 Rome, Italy;
| | - Maurizio Marceca
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy; (F.T.); (E.M.); (A.J.); (D.G.); (M.T.); (A.A.); (M.M.)
| |
Collapse
|
41
|
Land-Use Change and Health Risks in the Process of Urbanization: A Spatiotemporal Interpretation of a Typical Case in Changzhou, China. LAND 2021. [DOI: 10.3390/land10080820] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
China has undergone rapid urban expansion in recent decades. At the same time, environmental pollution and its risk to public health have increased. However, the relationship between urban land-use changes and health is ambiguous and insufficiently understood. Based on a typical city-scale case—namely, Changzhou, China—this research aimed to interpret the evolution of health risks alongside land-use change during the process of urbanization. We gathered data from multiple sources, including population mortality data, socioeconomic data, remote-sensing images, data for the points of interest of enterprises, and relevant information on environmental health events and cancers. The results showed that Changzhou’s urbanization was typical insofar as it was characterized by massive growth in industry, a rapid increase in the urban population, and urban land expansion. Health risks related to environmental pollution increased considerably with urban land expansion over time, and they increased with proximity to the pollution. The results from a generalized linear model confirmed that Changzhou’s urbanization triggered increasing health risks. Our study interpreted the relationship between urban land expansion and health risks from a spatiotemporal perspective. It can be used as a reference for urban planning and policymaking with regard to urban environmental health.
Collapse
|
42
|
Hasson R, Sallis JF, Coleman N, Kaushal N, Nocera VG, Keith N. COVID-19: Implications for Physical Activity, Health Disparities, and Health Equity. Am J Lifestyle Med 2021; 16:420-433. [PMID: 35855783 PMCID: PMC9283961 DOI: 10.1177/15598276211029222] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Physical activity is one of the most efficacious pathways to promoting mental and physical health, preventing disease, and, most important during the COVID-19 pandemic, bolstering a stronger immune system. Efforts to “flatten the curve” have resulted in the temporary closure of exercise facilities and gyms, suspension of sport activities, and advisories to avoid public recreational spaces. All of these changes have made traditional opportunities to be physically active difficult to access. These changes have also exacerbated existing disparities in access to social and environmental supports for physical activity, potentially contributing to a widening gap in physical activity participation among those at greatest risk for COVID-19. Physical activity can play a special role in reducing the inequitable consequences of COVID-19; however, expansion and better targeting of evidence-informed interventions are needed that address the unique barriers present in communities that have been economically and socially marginalized to achieve health equity in COVID-19 outcomes. This review highlights effective and feasible strategies that provide more equitable access to physical activity programs and spaces across the United States. With a renewed investment in physical activity, this behavior can play a crucial role in improving population health and reducing disparities during the COVID-19 pandemic and beyond.
Collapse
Affiliation(s)
- Rebecca Hasson
- Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan (RH); Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California (JFS); The Goldberg Center for Community Pediatric Health, Children’s National Hospital, Washington, DC (NC); Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana (NK); Department of Health and Human Performance, Plymouth State
| | - James F. Sallis
- Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan (RH); Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California (JFS); The Goldberg Center for Community Pediatric Health, Children’s National Hospital, Washington, DC (NC); Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana (NK); Department of Health and Human Performance, Plymouth State
| | - Nailah Coleman
- Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan (RH); Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California (JFS); The Goldberg Center for Community Pediatric Health, Children’s National Hospital, Washington, DC (NC); Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana (NK); Department of Health and Human Performance, Plymouth State
| | - Navin Kaushal
- Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan (RH); Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California (JFS); The Goldberg Center for Community Pediatric Health, Children’s National Hospital, Washington, DC (NC); Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana (NK); Department of Health and Human Performance, Plymouth State
| | - Vincenzo G. Nocera
- Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan (RH); Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California (JFS); The Goldberg Center for Community Pediatric Health, Children’s National Hospital, Washington, DC (NC); Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana (NK); Department of Health and Human Performance, Plymouth State
| | - NiCole Keith
- Schools of Kinesiology and Public Health, University of Michigan, Ann Arbor, Michigan (RH); Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California (JFS); The Goldberg Center for Community Pediatric Health, Children’s National Hospital, Washington, DC (NC); Department of Health Sciences, School of Health and Human Sciences, Indiana University, Indianapolis, Indiana (NK); Department of Health and Human Performance, Plymouth State
| |
Collapse
|
43
|
Jiang TB, Deng ZW, Zhi YP, Cheng H, Gao Q. The Effect of Urbanization on Population Health: Evidence From China. Front Public Health 2021; 9:706982. [PMID: 34222193 PMCID: PMC8242255 DOI: 10.3389/fpubh.2021.706982] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 05/20/2021] [Indexed: 12/24/2022] Open
Abstract
This paper explores the relationship between urbanization rate and death incidence by applying panel threshold regression model to the inland provinces of China. The empirical results highlight that there is a nonlinear single threshold effect between urbanization and population health indicators. In China's inland provinces, the negative impact of urbanization on death rate is reduced when per capita GDP exceeds the threshold, that is, the positive impact of urbanization on population health is significantly weakened. Similarly, this result can also be applied to the north provinces, while there is a no threshold effect in south. These asymmetric effects are strongly related to geographical location, historical background, economic development conditions, and health policies. Therefore, in the urbanization process, while promoting the steady development of population urbanization, the government should also increase health investment to improve the system and mechanism, formulate policies to raise health awareness, protect residents' health and reduce the waste of health resources.
Collapse
Affiliation(s)
- Tuan-Biao Jiang
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | - Zi-Wei Deng
- School of Economics and Management, Guangxi Normal University, Guilin, China
| | - Yu-Peng Zhi
- Business School, Guangxi University, Nanning, China
| | - Hao Cheng
- College of Economics and Management, Nanning Normal University, Nanning, China
| | - Qing Gao
- Graduate School, Nanning Normal University, Nanning, China
| |
Collapse
|
44
|
Mental Well-Being and the Influence of Place: Conceptual Approaches for the Built Environment for Planning Healthy and Walkable Cities. SUSTAINABILITY 2021. [DOI: 10.3390/su13116395] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Promotion of healthy cities has prompted urban planners and designers to build new conceptual frameworks to improve the design of public spaces, in which mental well-being emerges as a fundamental concept. Mental well-being is related to spatial design, with increasing attention being paid to the built environment as an important predictor of mental well-being. The objective of this article is to advance and contribute new knowledge about the characteristics of the built environment and its potential benefits for mental well-being. A meta-analysis is carried out on various empirical and theoretical approaches from the literature. Using a WOS database as a case study, a methodology based on a bibliometric analysis is proposed to examine which elements of the built environment impact mental well-being in research between 1975 and 2020, using the HistCites and VOSviewer tools. The results show that there are six thematic axes related to the built environment that would favor greater mental well-being in public spaces: walkability, density, spatial design, environmental noise, green areas and social interaction. The six thematic axes are critically analyzed and integrated into a conceptual framework to address the impacts of the built environment on mental well-being in the planning of cities. It concludes with a discussion on the implications of these concepts for urban public policy and the promotion of healthier and more sustainable and walkable environments in Latin American cities.
Collapse
|
45
|
Brenner JM, Blutinger E, Ricke B, Vearrier L, Kluesner NH, Moskop JC. Ethical issues in the access to emergency care for undocumented immigrants. J Am Coll Emerg Physicians Open 2021; 2:e12461. [PMID: 34095898 PMCID: PMC8164497 DOI: 10.1002/emp2.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/30/2021] [Accepted: 05/05/2021] [Indexed: 11/24/2022] Open
Abstract
Patients who are undocumented immigrants (UIs) frequently present to emergency departments in the United States, especially in communities with large immigrant populations. Emergency physicians confront important ethical issues when providing care for these patients. This article examines those ethical issues and recommends best practices in emergency care for UIs. After a brief introduction and description of the UI population, the article proposes central principles of emergency medical ethics as a framework for emergency physician decisions and actions. It then considers the role of law and public policy in health care for UIs, including the Emergency Medical Treatment and Labor Act, the Patient Protection and Affordable Care Act, and current practices of the US Immigration and Customs Enforcement agency. The article concludes with discussion of the scope of emergency physician practice and with recommendations regarding best practices in ED care for UIs.
Collapse
Affiliation(s)
- Jay M. Brenner
- Department of Emergency MedicineSUNY‐Upstate Medical UniversitySyracuseNew YorkUSA
| | - Erik Blutinger
- Department of Emergency MedicineIcahn School of MedicineNew YorkNew YorkUSA
| | - Brandon Ricke
- Department of Emergency MedicineUniversity of KansasKansas CityKansasUSA
| | - Laura Vearrier
- Department of Emergency MedicineUniversity of Mississippi Medical CenterJacksonMississippiUSA
| | | | - John C. Moskop
- Department of Internal MedicineWake Forest School of MedicineWinston‐SalemNorth CarolinaUSA
| |
Collapse
|
46
|
Tuhebwe D, Babirye S, Ssendagire S, Ssengooba F. The extent to which the design of available reproductive health interventions fit the reproductive health needs of adolescents living in urban poor settings of Kisenyi, Kampala, Uganda. BMC Public Health 2021; 21:933. [PMID: 34001043 PMCID: PMC8130317 DOI: 10.1186/s12889-021-10933-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 04/28/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND The rate at which informal urban settlements (slums) are developing in Low and Middle Income. Countries (LMICs) like Uganda is high. With this, comes the growing intersection between urbanization and the reproductive health of key populations. Currently, a number of interventions are being implemented to improve the Reproductive Health (RH) of adolescents in Kisenyi, the largest informal urban settlement in Kampala, the capital of Uganda. Despite these efforts, adolescent RH indicators have persistently remained poor in Kisenyi. This could be indicative of a gap between the provided and needed adolescent RH interventions. We assessed the fit between the available interventions and the RH needs of adolescents living in Kisenyi. METHODS We conducted a qualitative study in July 2019-February 2020 in Kisenyi. The methodology was guided by the Word Health Organization global standards for quality-health care services for adolescents, the "For whom? Where? By whom? and What?" Framework of sexual RH service delivery and the realist evaluation approach. Eight focus group discussions were conducted with adolescents 15-19 years to explore their RH needs. The design and implementation of the available adolescent RH interventions were assessed by conducting Key Informant interviews with 10 RH service providers in Kisenyi. Validation meetings were held with adolescents and they scored the extent to which the various design features of the existing interventions fit the adolescents' RH needs. RESULTS The available RH interventions focused on meeting the sexual RH needs like providing family planning services but less on social needs like livelihood and sanitation which the adolescents identified as equally important. While the providers designed intervention to target 10-24 year olds, the adolescents preferred to have interventions that specifically targeted the study population 15-19 years. Most interventions were facility-based while, the adolescents desired community based outreaches. CONCLUSION The packaging and mode of delivery of interventions were perceived less holistic to meet the adolescents' needs. Most interventions were designed to address the sexual and family planning needs while ignoring the wider social and livelihood needs. More holistic and outreach-based programming that addresses RH within the broader context of livelihood and sanitation requirements are more likely to be effective.
Collapse
Affiliation(s)
- Doreen Tuhebwe
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda.
| | - Susan Babirye
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Steven Ssendagire
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| | - Freddie Ssengooba
- Department of Health Policy, Planning and Management, School of Public Health, Makerere University, Kampala, Uganda
| |
Collapse
|
47
|
Ferreira PL, Raposo V, Tavares AI, Pinto A. Burnout and health status differences among primary healthcare professionals in Portugal. BMC FAMILY PRACTICE 2021; 22:81. [PMID: 33910526 PMCID: PMC8082847 DOI: 10.1186/s12875-021-01425-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 03/29/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND This paper is focused on two indicators which may be considered as proxies of individuals' well-being: self-assessed health and burnout intensity. There is little research relating these concepts with the type of the primary healthcare setting, its urbanization density and the region. The aims of this work are threefold: (i) to find determinant factors of individual health status and burnout, (ii) to find possible differences across different types of health care units, differently urbanized areas, and different administrative regions, and (iii) to verify if there are differences in between GPs and nurses. METHODS Data was gathered from an online questionnaire implemented on primary health care. A sample of 9,094 professionals from all 1,212 primary health care settings in Portugal mainland was obtained from an online questionnaire filled from January and April 2018. Statistical analyses include the estimation of two ordered probits, one explaining self-assessed health and the other the burnout. RESULTS The individual drivers for good health and lower levels of burnout, that is, better well-being, are estimated for GPs and nurses. Main findings support that, first, nurses report worst health than GPs, but the latter tend to suffer higher levels of burnout, and also that, 'place' effects arising from the health unit settings and regional location are more significant in GPs than in nurses. However, urbanization density is not significantly associated with health or burnout. CONCLUSIONS A set of policy recommendations are suggested to improve the healthcare workforce well-being, such as improving job satisfaction and income. These policies should be taken at the health care unit level and at the regional administrative level.
Collapse
Affiliation(s)
- Pedro L Ferreira
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Vitor Raposo
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FEUC - Faculty of Economics, University of Coimbra, Coimbra, Portugal
| | - Aida Isabel Tavares
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal.
- ISEG -UL - Lisbon School of Economics and Management, University of Lisbon, Lisbon, Portugal.
| | - Ana Pinto
- CEISUC - Centre for Health Studies and Research, University of Coimbra, Coimbra, Portugal
- FCTUC - Faculty of Science and Technology, University of Coimbra, Coimbra, Portugal
| |
Collapse
|
48
|
Zakharova OI, Korennoy FI, Iashin IV, Toropova NN, Gogin AE, Kolbasov DV, Surkova GV, Malkhazova SM, Blokhin AA. Ecological and Socio-Economic Determinants of Livestock Animal Leptospirosis in the Russian Arctic. Front Vet Sci 2021; 8:658675. [PMID: 33912609 PMCID: PMC8071861 DOI: 10.3389/fvets.2021.658675] [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: 01/26/2021] [Accepted: 03/15/2021] [Indexed: 11/19/2022] Open
Abstract
Leptospirosis is a re-emerging zoonotic infectious disease caused by pathogenic bacteria of the genus Leptospira. Regional differences in the disease manifestation and the role of ecological factors, specifically in regions with a subarctic and arctic climate, remain poorly understood. We here explored environmental and socio-economic features associated with leptospirosis cases in livestock animals in the Russian Arctic during 2000–2019. Spatial analysis suggested that the locations of the majority of 808 cases were in “boreal” or “polar” climate regions, with “cropland,” “forest,” “shrubland,” or “settlements” land-cover type, with a predominance of “Polar Moist Cropland on Plain” ecosystem. The cases demonstrated seasonality, with peaks in March, June, and August, corresponding to the livestock pasturing practices. We applied the Forest-based Classification and Regression algorithm to explore the relationships between the cumulative leptospirosis incidence per unit area by municipal districts (G-rate) and a number of socio-economic, landscape, and climatic factors. The model demonstrated satisfactory performance in explaining the observed disease distribution (R2 = 0.82, p < 0.01), with human population density, livestock units density, the proportion of crop area, and budgetary investments into agriculture per unit area being the most influential socio-economic variables. Climatic factors demonstrated a significantly weaker influence, with nearly similar contributions of mean yearly precipitation and air temperature and number of days with above-zero temperatures. Using a projected climate by 2100 according to the RCP8.5 scenario, we predict a climate-related rise of expected disease incidence across most of the study area, with an up to 4.4-fold increase in the G-rate. These results demonstrated the predominant influence of the population and agricultural production factors on the observed increase in leptospirosis cases in livestock animals in the Russian Arctic. These findings may contribute to improvement in the regional system of anti-leptospirosis measures and may be used for further studies of livestock leptospirosis epidemiology at a finer scale.
Collapse
Affiliation(s)
- Olga I Zakharova
- Federal Research Center for Virology and Microbiology, Nizhny Novgorod Research Veterinary Institute-Branch of Federal Research Center for Virology and Microbiology, Nizhny Novgorod, Russia
| | - Fedor I Korennoy
- Federal Research Center for Virology and Microbiology, Nizhny Novgorod Research Veterinary Institute-Branch of Federal Research Center for Virology and Microbiology, Nizhny Novgorod, Russia.,Federal Center for Animal Health (FGBI ARRIAH), Vladimir, Russia
| | - Ivan V Iashin
- Federal Research Center for Virology and Microbiology, Nizhny Novgorod Research Veterinary Institute-Branch of Federal Research Center for Virology and Microbiology, Nizhny Novgorod, Russia
| | - Nadezhda N Toropova
- Federal Research Center for Virology and Microbiology, Nizhny Novgorod Research Veterinary Institute-Branch of Federal Research Center for Virology and Microbiology, Nizhny Novgorod, Russia
| | - Andrey E Gogin
- Federal Research Center for Virology and Microbiology, Pokrov, Russia
| | - Denis V Kolbasov
- Federal Research Center for Virology and Microbiology, Pokrov, Russia
| | - Galina V Surkova
- Faculty of Geography, Lomonosov Moscow State University, Moscow, Russia
| | | | - Andrei A Blokhin
- Federal Research Center for Virology and Microbiology, Nizhny Novgorod Research Veterinary Institute-Branch of Federal Research Center for Virology and Microbiology, Nizhny Novgorod, Russia
| |
Collapse
|
49
|
Meroni G, Valerio A, Vezzoli M, Croci E, Carruba MO. The relationship between air pollution and diabetes: A study on the municipalities of the Metropolitan City of Milan. Diabetes Res Clin Pract 2021; 174:108748. [PMID: 33713719 DOI: 10.1016/j.diabres.2021.108748] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/06/2021] [Accepted: 03/01/2021] [Indexed: 11/17/2022]
Abstract
AIMS Urbanisation has been linked with an increased risk of developing diabetes mellitus, dramatically worsening the healthcare system's financial burden. Environmental influences are emerging among the causing factors of the urban diabetes epidemic. We evaluated the relationship between air pollution and the prevalence of diabetes in the Municipalities of the Metropolitan City of Milan, comprising more than 3,4 million citizens. METHODS The prevalence of diabetes in the resident population and the mean annual air concentrations of PM10 and NO2 were retrieved from the municipal Agency for Health Protection and the regional Agency for Ambient Protection datasets. Two linear regression models were estimated to inspect the relationships between the (logit-based transformed) diabetes prevalence and air pollution concentrations, namely: (i) PM10, and (ii) NO2. Both models were adjusted for five control variables, including the qualitative variable year (2011-2018). RESULTS Both models highlight a statistically significant positive relationship between air pollutants and diabetes prevalence. An increase of one PM10 or NO2 concentrations' unit translates into a rise of 0.81% or 0.41% in diabetes prevalence, respectively. CONCLUSION Our results contribute to the ongoing research regarding health outcomes of urbanisation dynamics and should be considered in city planning policies.
Collapse
Affiliation(s)
| | - Alessandra Valerio
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| | - Marika Vezzoli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Edoardo Croci
- GREEN - Center for Geography, Resources, Environment, Energy and Networks, Bocconi University, Milan, Italy
| | - Michele O Carruba
- Center for the Study and Research on Obesity, Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| |
Collapse
|
50
|
Nampijja M, Okelo K, Wekulo PK, Kimani-Murage EW, Elsey H. Improving the quality of child-care centres through supportive assessment and 'communities of practice' in informal settlements in Nairobi: protocol of a feasibility study. BMJ Open 2021; 11:e042544. [PMID: 33674370 PMCID: PMC7938982 DOI: 10.1136/bmjopen-2020-042544] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Investing in children during the critical period between birth and age 5 years can have long-lasting benefits throughout their life. Children in Kenya's urban informal settlements, face significant challenges to healthy development, particularly when their families need to earn a daily wage and cannot care for them during the day. In response, informal and poor quality child-care centres with untrained caregivers have proliferated. We aim to co-design and test the feasibility of a supportive assessment and skills-building for child-care centre providers. METHODS AND ANALYSIS A sequential mixed-methods approach will be used. We will map and profile child-care centres in two informal settlements in Nairobi, and complete a brief quality assessment of 50 child-care centres. We will test the feasibility of a supportive assessment skills-building system on 40 child-care centres, beginning with assessing centre-caregivers' knowledge and skills in these centres. This will inform the subsequent co-design process and provide baseline data. Following a policy review, we will use experience-based co-design to develop the supportive assessment process. This will include qualitative interviews with policymakers (n=15), focus groups with parents (n=4 focus group discussions (FGDs)), child-care providers (n=4 FGDs) and joint workshops. To assess feasibility and acceptability, we will observe, record and cost implementation for 6 months. The knowledge/skills questionnaire will be repeated at the end of implementation and results will inform the purposive selection of 10 child-care providers and parents for qualitative interviews. Descriptive statistics and thematic framework approach will respectively be used to analyse quantitative and qualitative data and identify drivers of feasibility. ETHICS AND DISSEMINATION The study has been approved by Amref Health Africa's Ethics and Scientific Review Committee (Ref: P7802020 on 20th April 2020) and the University of York (Ref: HSRGC 20th March 2020). Findings will be published and continual engagement with decision-makers will embed findings into child-care policy and practice.
Collapse
Affiliation(s)
- Margaret Nampijja
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Kenneth Okelo
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | - Patricia Kitsao Wekulo
- Maternal and Child Wellbeing Unit, African Population and Health Research Center, Nairobi, Kenya
| | | | - Helen Elsey
- Department of Health Sciences, University of York, York, UK
| |
Collapse
|