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McDaniel AM, Cooley ME, Andrews JO, Bialous S, Buettner-Schmidt K, Heath J, Okoli C, Timmerman GM, Sarna L. Nursing leadership in tobacco dependence treatment to advance health equity: An American Academy of Nursing policy manuscript. Nurs Outlook 2024; 72:102236. [PMID: 39043053 DOI: 10.1016/j.outlook.2024.102236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 06/15/2024] [Accepted: 06/22/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Tobacco use remains the leading cause of preventable disease, disability, and death in the United States and is a significant cause of health disparities. PURPOSE The purpose of this paper is to update the Tobacco Control policy paper published over a decade ago by the American Academy of Nursing's Health Behavior Expert Panel Tobacco Control subcommittee. METHODS Members reviewed and synthesized published literature from 2012 to 2024 to identify the current state of the science related to nurse-led tobacco dependence treatment and implications for nursing practice, education, and research. FINDINGS The results confirmed that nurse-led tobacco dependence treatment interventions are successful in enhancing cessation outcomes across settings. DISCUSSION Recommendations for nursing leaders include: promote tobacco dependence treatment as standard care, accelerate research on implementation of evidence-based treatment guidelines, reduce health disparities by extending access to evidence-based treatment, increase nursing competency in providing tobacco treatment, and drive equity-focused tobacco control policies.
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Affiliation(s)
- Anna M McDaniel
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC.
| | - Mary E Cooley
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Jeannette O Andrews
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Stella Bialous
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Kelly Buettner-Schmidt
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Janie Heath
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Chizimuzo Okoli
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Gayle M Timmerman
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
| | - Linda Sarna
- Health Behavior Expert Panel (Tobacco Control Sub-group), American Academy of Nursing, Washington, DC
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Jennings V, Rigolon A, Thompson J, Murray A, Henderson A, Gragg RS. The Dynamic Relationship between Social Cohesion and Urban Green Space in Diverse Communities: Opportunities and Challenges to Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:800. [PMID: 38929046 PMCID: PMC11204079 DOI: 10.3390/ijerph21060800] [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: 04/10/2024] [Revised: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 06/28/2024]
Abstract
Social cohesion is a key factor within social determinants of health and well-being. Urban green spaces can provide environments that potentially facilitate meaningful and positive social interactions that promote social cohesion, equity, human health, and well-being. However, the lack of integration of existing research on social cohesion, urban green spaces, and public health in diverse (e.g., racially and ethnically) communities limits culturally relevant strategies to address health disparities. In this manuscript, we synthesize research on the potential of urban green spaces to promote social cohesion and public health in historically excluded communities. Particularly, we explore the development of social cohesion as it relates to the social environment, built environment, leisure opportunities, green space maintenance, safety, and green gentrification. We highlight key factors and their application to meet opportunities and challenges to social and public health. A conceptual framework is presented to provide an overview and illustrate connections found in the literature.
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Affiliation(s)
- Viniece Jennings
- School of the Environment, Florida Agricultural and Mechanical University, Tallahassee, FL 32307, USA;
| | - Alessandro Rigolon
- Department City and Metropolitan Planning, The University of Utah, Salt Lake City, UT 84112, USA
| | - Jasmine Thompson
- Department of Public Health, Agnes Scott College, Decatur, GA 30030, USA
| | - Athena Murray
- Department of Public Health, Agnes Scott College, Decatur, GA 30030, USA
| | - Ariel Henderson
- Department of Public Health, Agnes Scott College, Decatur, GA 30030, USA
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Liu MA, Brett EI, Chavarria J, King AC. Trying is believing: A pilot study of in-vivo nicotine replacement therapy sampling in disadvantaged Black adults who smoke cigarettes. Drug Alcohol Depend 2022; 241:109679. [PMID: 36332594 DOI: 10.1016/j.drugalcdep.2022.109679] [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] [Received: 05/15/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION While nicotine replacement therapy (NRT) is a frontline tobacco treatment that doubles smoking quit rates, only about 18% of Black adults who smoke cigarettes report lifetime use of NRT. A promising approach for increasing NRT use is in-session (in-vivo) NRT sampling within cessation interventions. The present pilot study examined the effectiveness of an in-vivo NRT sampling intervention within a single-session, culturally-targeted motivational intervention trial in Black adults who smoke cigarettes. METHODS Non-treatment-seeking disadvantaged Black adults (N = 60) were offered the choice to sample nicotine lozenge, patch, or both in-session with the counselor present. Regardless of their choice, they were offered a one-week starter kit of both products. Data were analyzed at baseline and 1-month follow-up. Primary outcomes were 1) differences in motivation to quit smoking among NRT samplers versus non-samplers, 2) in-vivo NRT sampling preferences, and 3) in-vivo sampling's association with NRT use and improved smoking outcomes at follow up. RESULTS Almost all participants accepted a take-home NRT starter kit, and approximately half of those offered in-vivo sampling agreed to sample. Participants preferred sampling lozenges in session (75.8% lozenge only vs. 12.1% nicotine patch only or 12.1% both; p < .001). Motivation to quit smoking was not related to likelihood of in-vivo NRT sampling (p > .05). At 1-month follow-up, in-vivo samplers were more likely to use NRT (94% vs. 35%, respectively; p < .001) and report a quit attempt (81.8% vs. 53.9%, p < .05) compared to non-samplers. CONCLUSION In-vivo NRT sampling is a promising strategy to improve NRT uptake among Black adults who smoke cigarettes, regardless of motivation to quit smoking.
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Affiliation(s)
- Melissa A Liu
- Indiana University, Purdue University Indianapolis, USA.
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Marçal KE, Maguire-Jack K. Informal supports, housing insecurity, and adolescent outcomes: Implications for promoting resilience. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:178-196. [PMID: 35156209 DOI: 10.1002/ajcp.12589] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/09/2021] [Accepted: 01/12/2022] [Indexed: 06/14/2023]
Abstract
Adolescents in low-income, marginalized families are vulnerable to behavior problems that impede healthy functioning and threaten long-term well-being. Informal supports may fill an important gap for these households as they navigate financial and social stressors. Instrumental support from social networks and neighborhood cohesion may promote family stability and youth well-being; further, these informal supports may promote resilience to housing insecurity, which is linked with a range of adverse adolescent outcomes. The present study utilized data from a large sample of at-risk families with children (N = 2425) to investigate whether instrumental support and neighborhood cohesion predicted adolescent behavior problems over 10 years and whether these links were mediated by housing insecurity. Results of structural equation modeling with latent variables showed direct links from instrumental support to anxious/depressed behaviors and from neighborhood cohesion to aggressive behaviors, as well as an indirect link from instrumental support to aggressive behavior via housing insecurity. Findings suggest informal supports are an important source of resilience for low-income families who may be excluded from or are reluctant to engage with formal social systems. Further, stable, connected communities with highly embedded social networks can promote housing stability and youth well-being in a virtuous cycle.
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Affiliation(s)
- Katherine E Marçal
- Greenspun College of Urban Affairs, University of Nevada, Las Vegas, Nevada, USA
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King LM, Barnett TE, Allen AC, Maizel JL, Wilson RE. Tobacco-related health inequalities among Black Americans: A narrative review of structural and historical influences. J Ethn Subst Abuse 2022:1-31. [PMID: 35839212 DOI: 10.1080/15332640.2022.2093812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We conducted a narrative literature review to examine contributing factors of disparities in tobacco usage and outcomes affecting Black Americans. We propose potential solutions that can be used to effectively address these disparities. We identified historical factors; socioeconomic factors; targeted marketing/advertising; the influence of racism/discrimination; neighborhood socioeconomic disadvantage; and mass incarceration. We call for more thorough examinations of these factors as a key element of tobacco-focused research and interventions to eliminate the disproportionate burdens faced by Black Americans. We advocate for greater emphases on the impacts of personal and structural racism on tobacco usage and outcomes affecting Black Americans.
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Affiliation(s)
| | - Tracey E Barnett
- University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas
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Liu Y, Liu Z, Liang R, Luo Y. The association between community-level socioeconomic status and depressive symptoms among middle-aged and older adults in China. BMC Psychiatry 2022; 22:297. [PMID: 35484534 PMCID: PMC9047288 DOI: 10.1186/s12888-022-03937-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 04/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There was little evidence concerning the association of community socioeconomic status (SES) and the cross-level interaction between community- and individual-level SES with depressive symptoms in China. This study aimed to investigate the association of community-level SES with depressive symptoms among Chinese middle-aged and older people and to examine whether individual-level SES moderates this relationship. METHODS Using data from the China Health and Retirement Longitudinal 2011-2018 Study, the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) short form was used to measure depressive symptoms in 35,546 Chinese individuals aged 45 years and older. Community SES was calculated as a sum of z scores of the average years of schooling and household income per capita, which were derived by aggregating the individual measures to the community level. Two-level hierarchical linear regression was used. RESULTS Community SES was negatively related to CES-D-10 scores (coef=-0.438). A 1-SD increase in individual SES was associated with lower CES-D-10 scores (coef=-0.490). The cross-level interaction on individual- and community-level SES was significantly associated with depressive symptoms, indicating that with the increase of individual-level SES, the effect of community-level SES on depression decreases. Stratified analyses observed robust associations of community SES with CES-D scores between urban and rural residents. CONCLUSIONS This study showed that individuals who live in lower-SES communities had more severe depressive symptoms, particularly individuals with low SES. Additional attention should be given to the community socioeconomic context of middle-aged and older adults with lower SES, which may be helpful to reduce SES inequalities in depressive symptoms in China.
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Affiliation(s)
- Yan Liu
- grid.11135.370000 0001 2256 9319Institute of Population Research, Peking University, Beijing, China
| | - Zhaorui Liu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Beijing, China
| | - Richard Liang
- grid.168010.e0000000419368956School of Medicine, Stanford University, Palo Alto, California USA
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, No.38 Xueyuan Road, Haidian District, 100191, Beijing, China.
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Do DP, Zheng C. Examining the impacts of neighborhood poverty on bodyweight across the BMI distribution: a quantile and MSM modeling approach. Ann Epidemiol 2021; 64:33-40. [PMID: 34500084 DOI: 10.1016/j.annepidem.2021.08.024] [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: 02/10/2021] [Revised: 07/28/2021] [Accepted: 08/27/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE Given that the relationships between higher BMI and adverse health outcomes are nonconstant and most pronounced at either ends of the BMI distribution, we assess the association between neighborhood poverty and BMI at multiple points along the BMI distribution. METHODS Using data from the 1999 to 2015 Panel Study of Income Dynamics of Black and White adults in the United States, we estimate quantile regression models while jointly applying a marginal structural modeling approach to account for time-varying individual-level factors that may be simultaneously mediators as well as confounders. RESULTS Neighborhood poverty was not found to be associated with bodyweight at any point along the BMI distribution for Black or White males. However, high neighborhood poverty, compared to low neighborhood poverty, predicted increases in bodyweight for Black females at the lower end of the BMI distribution and for White females at the higher end of the BMI distribution. No association was found between neighborhood poverty and BMI at the mean. CONCLUSIONS Results identify the most vulnerable subgroups, suggesting that White females at the higher end of the BMI distribution as well as Black females at the lower end of the BMI distribution are particularly sensitive to obesogenic environments.
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Affiliation(s)
- D Phuong Do
- Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI.
| | - Cheng Zheng
- University of Nebraska Medical Center, Department of Biostatistics, Omaha, NE 68198
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Feng Z, Cramm JM, Nieboer AP. Associations of Social Cohesion and Socioeconomic Status with Health Behaviours among Middle-Aged and Older Chinese People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094894. [PMID: 34064460 PMCID: PMC8125501 DOI: 10.3390/ijerph18094894] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/27/2021] [Accepted: 05/02/2021] [Indexed: 11/16/2022]
Abstract
Background: An understanding of factors associated with health behaviours is critical for the design of appropriate health promotion programmes. Important influences of social cohesion, education, and income on people's health behaviours have been recognised in Western countries. However, little is known about these influences in the older Chinese population. Objective: To investigate associations of social cohesion and socioeconomic status (SES) with health behaviours among middle-aged and older adults in China. Methods: We used data from the World Health Organization's Study on Global AGEing and Adult Health. Logistic regression and multivariate linear regression were performed. Results: Participants who reported greater social cohesion were more likely to have adequate vegetable and fruit (VF) consumption, be socially active, and less likely to smoke daily, but were not physically more active; participants with lower education levels were less likely to have adequate VF consumption and be socially active, and more likely to smoke daily; higher incomes were associated with decreased odds of daily smoking, increased odds of adequate VF consumption, increased likelihood to be socially active, but also less likelihood to have sufficient physical activity (PA). Associations of social cohesion and SES with health behaviours (smoking, PA, and VF consumption) differed between men and women. Discussion: Our findings are an essential step toward a fuller understanding of the roles of social cohesion and SES in protecting healthy behaviours among older adults.
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Affiliation(s)
- Zeyun Feng
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands; (J.M.C.); (A.P.N.)
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai 200031, China
- Correspondence:
| | - Jane M. Cramm
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands; (J.M.C.); (A.P.N.)
| | - Anna P. Nieboer
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, 3000 DR Rotterdam, The Netherlands; (J.M.C.); (A.P.N.)
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Phan L, Beck K, Wang MQ, Butler J. The Development and Initial Validation of a Health Belief Model Scale to Reduce Single Cigarette Use among Urban, African American Smokers. AMERICAN JOURNAL OF HEALTH EDUCATION 2020. [DOI: 10.1080/19325037.2020.1795755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | | | - Min Qi Wang
- University of Maryland School of Public Health
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Ceasar JN, Ayers C, Andrews MR, Claudel SE, Tamura K, Das S, de Lemos J, Neeland IJ, Powell-Wiley TM. Unfavorable perceived neighborhood environment associates with less routine healthcare utilization: Data from the Dallas Heart Study. PLoS One 2020; 15:e0230041. [PMID: 32163470 PMCID: PMC7067436 DOI: 10.1371/journal.pone.0230041] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 02/20/2020] [Indexed: 11/18/2022] Open
Abstract
Neighborhood environment perception (NEP) has been associated with health outcomes. However, little is known about how NEP relates to routine healthcare utilization. This study investigated the relationship between NEP and independent subfactors with healthcare utilization behavior, as measured by self-reported (1) usual source of healthcare and (2) time since last routine healthcare check-up. We used cross-sectional data from the Dallas Heart Study, which features a diverse, probability-based sample of Dallas County residents ages 18 to 65. We used logistic regression modeling to examine the association of self-reported NEP and routine healthcare utilization. NEP was assessed via a questionnaire exploring residents' neighborhood perceptions, including violence, the physical environment, and social cohesion. Routine healthcare utilization was assessed via self-reported responses regarding usual source of care and time since last routine healthcare check-up. The analytic sample (N = 1706) was 58% black, 27% white, 15% Hispanic, 42% male, and had a mean age of 51 (SD = 10.3). Analysis of NEP by tertile demonstrated that younger age, lower income, and lower education were associated with unfavorable overall NEP (p trend <0.05 for each). After adjustment for potential confounders, including neighborhood deprivation, health insurance, disease burden and psychosocial factors, we found that individuals with more unfavorable perception of their physical environment were more likely to report lack of a usual source of care (p = 0.013). Individuals with more unfavorable perception of the neighborhood physical environment or greater neighborhood violence reported longer time periods since last routine visit (p = 0.001, p = 0.034 respectively). There was no relationship between perceived social cohesion and healthcare utilization. Using a multi-ethnic cohort, we found that NEP significantly associates with report of a usual source of care and time since last routine check-up. Our findings suggest that public health professionals should prioritize improving NEP since it may act as barrier to routine preventive healthcare and ideal health outcomes.
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Affiliation(s)
- Joniqua N. Ceasar
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Colby Ayers
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Marcus R. Andrews
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sophie E. Claudel
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Kosuke Tamura
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Sandeep Das
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - James de Lemos
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Ian J. Neeland
- University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Tiffany M. Powell-Wiley
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, United States of America
- * E-mail:
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Kock L, Brown J, Hiscock R, Tattan-Birch H, Smith C, Shahab L. Individual-level behavioural smoking cessation interventions tailored for disadvantaged socioeconomic position: a systematic review and meta-regression. Lancet Public Health 2019; 4:e628-e644. [PMID: 31812239 PMCID: PMC7109520 DOI: 10.1016/s2468-2667(19)30220-8] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Socioeconomic inequalities in smoking cessation have led to development of interventions that are specifically tailored for smokers from disadvantaged groups. We aimed to assess whether the effectiveness of interventions for disadvantaged groups is moderated by tailoring for socioeconomic position. METHODS For this systematic review and meta-regression, we searched MEDLINE, PsycINFO, Embase, Cochrane Central Register, and Tobacco Addiction Register of Clinical Trials and the IC-SMOKE database from their inception until Aug 18, 2019, for randomised controlled trials of socioeconomic-position-tailored or non-socioeconomic-position-tailored individual-level behavioural interventions for smoking cessation at 6 months or longer of follow-up in disadvantaged groups. Studies measured socioeconomic position via income, eligibility for government financial assistance, occupation, and housing. Studies were excluded if they were delivered at the community or population level, did not report differential effects by socioeconomic position, did not report smoking cessation outcomes from 6 months or longer after the start of the intervention, were delivered at a group level, or provided pharmacotherapy with standard behavioural support compared with behavioural support alone. Individual patient-level data were extracted from published reports and from contacting study authors. Random-effects meta-analyses and mixed-effects meta-regression analyses were done to assess associations between tailoring of the intervention and effectiveness. Meta-analysis outcomes were summarised as risk ratios (RR). Certainty of evidence was assessed within each study using the Cochrane risk-of-bias tool version 2 and the grading of recommendations assessment, development, and evaluation approach. The study is registered with PROSPERO, CRD42018103008. FINDINGS Of 2376 studies identified by our literature search, 348 full-text articles were retrieved and screened for eligibility. Of these, 42 studies (26 168 participants) were included in the systematic review. 30 (71%) of 42 studies were done in the USA, three (7%) were done in the UK, two (5%) each in the Netherlands and Australia, and one (2%) each in Switzerland, Sweden, Turkey, India, and China. 26 (62%) of 42 studies were trials of socioeconomic-position-tailored interventions and 16 (38%) were non-socioeconomic-position-tailored interventions. 17 (65%) of 26 socioeconomic-position-tailored interventions were in-person or telephone-delivered behavioural interventions, four (15%) were digital interventions, three (12%) involved financial incentives, and two (8%) were brief interventions. Individuals who participated in an intervention, irrespective of tailoring, were significantly more likely to quit smoking than were control participants (RR 1·56, 95% CI 1·39-1·75; I2=54·5%). Socioeconomic-position-tailored interventions did not yield better outcomes compared with non-socioeconomic-position-tailored interventions for disadvantaged groups (adjusted RR 1·01, 95% CI 0·81-1·27; β=0·011, SE=0·11; p=0·93). We observed similar effect sizes in separate meta-analyses of non-socioeconomic-position-tailored interventions using trial data from participants with high socioeconomic position (RR 2·00, 95% CI 1·36-2·93; I2=82·7%) and participants with low socioeconomic position (1·94, 1·31-2·86; I2=76·6%), although certainty of evidence from these studies was graded as low. INTERPRETATION We found evidence that individual-level interventions can assist disadvantaged smokers with quitting, but there were no large moderating effects of tailoring for disadvantaged smokers. Improvements in tailored intervention development might be necessary to achieve equity-positive smoking cessation outcomes. FUNDING Cancer Research UK.
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Affiliation(s)
- Loren Kock
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.
| | - Jamie Brown
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | | | - Harry Tattan-Birch
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Charlie Smith
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
| | - Lion Shahab
- Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK
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Felker-Kantor EA, Cunningham-Myrie C, Greene LG, Lyew-Ayee P, Atkinson U, Abel W, Clarke P, Anderson SG, Theall KP. Neighborhood crime, disorder and substance use in the Caribbean context: Jamaica National Drug Use Prevalence Survey 2016. PLoS One 2019; 14:e0224516. [PMID: 31756190 PMCID: PMC6874353 DOI: 10.1371/journal.pone.0224516] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/15/2019] [Indexed: 12/02/2022] Open
Abstract
The purpose of the study was to examine the role of objective and subjective measures of neighborhood crime and disorder on substance use among a nationally representative sample of 4525 Jamaicans aged 12–65 years. Log-Poisson models with generalized estimating equations were used to estimate relative risks (RR) and 95% confidence intervals (CI). A test of interaction was used to determine presence of effect modification by sex. Approximately 39% of the study population reported past-month alcohol use; 10% past-month tobacco use; and 15% past-month marijuana use. In fully adjusted models, past-month alcohol and tobacco use were associated with perceived neighborhood disorder (p<0.05). The likelihood of alcohol use was 1.12 (95%CI:1.04, 1.20) times greater among participants who perceived higher neighborhood disorder. The likelihood of tobacco use was 1.22 (95%CI: 1.01, 1.46) times greater among participants who perceived higher neighborhood disorder. A significant test for interaction in adjusted models (P<0.2) suggested that the associations between substance use and perceived neighborhood disorder varied by sex. Examination of stratified models indicated that the role of perceived neighborhood disorder on alcohol and tobacco consumption varied among females, but not males. Females who perceived higher levels of neighborhood disorder had an increased likelihood of past-month alcohol and tobacco use (RRa:1.25 95%CI:1,07, 1.45; RRa:1.73 95%CI: 1.10, 2.67). Objective neighborhood crime measures were not associated with alcohol, tobacco, or marijuana use. The study findings provide evidence for the importance of considering subjective and objective neighborhood measures when examining relations with health outcome and demonstrate that perceptions of context and contextual exposures are not uniform across populations within neighborhoods. Interventions focused on building community trust and social cohesion (e.g. neighborhood community watch groups) and greening of blighted or abandoned spaces may help increase the sense of safety and order, reducing stress and maladaptive coping such as substance use.
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Affiliation(s)
- Erica Ann Felker-Kantor
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
| | - Colette Cunningham-Myrie
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
- * E-mail:
| | - Lisa-Gaye Greene
- Mona GeoInformatics Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Parris Lyew-Ayee
- Mona GeoInformatics Institute, University of the West Indies, Mona, Kingston, Jamaica
| | - Uki Atkinson
- National Council on Drug Abuse, Ministry of Health, Kingston, Jamaica
| | - Wendel Abel
- Department of Community Health and Psychiatry, University of the West Indies, Mona, Kingston, Jamaica
| | - Pernell Clarke
- Organization of American States, Inter-American Drug Abuse Control Commission, Washington, District of Columbia, United States of America
| | - Simon G. Anderson
- The George Alleyne Chronic Disease Research Centre, Caribbean Institute of Health Research, University of the West Indies, Cave Hill, Barbados
| | - Katherine P. Theall
- Department of Global Community Health and Behavioral Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America
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Latkin CA, Kennedy RD, Davey-Rothwell MA, Tseng TY, Czaplicki L, Baddela A, Edwards C, Chander G, Moran MB, Knowlton AR. The Relationship Between Neighborhood Disorder and Barriers to Cessation in a Sample of Impoverished Inner-City Smokers in Baltimore, Maryland, United States. Nicotine Tob Res 2019; 20:1451-1456. [PMID: 29126121 DOI: 10.1093/ntr/ntx252] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 11/08/2017] [Indexed: 11/13/2022]
Abstract
Introduction Economic disparities in rates of smoking have been well documented in many countries. These disparities exist on an individual and geographic or neighborhood level. This cross-sectional study examined the relationship between neighborhood physical and social disorder and barriers to smoking cessation among an impoverished urban sample. Methods A sample of current smokers were recruited through street outreach, posted advertisements, and word of mouth from impoverished neighborhoods in Baltimore, Maryland, USA for a study of psychosocial factors and smoking behaviors. Neighborhood disorder was assessed with a 10-item scale from the Block Environmental Inventory and barriers to cessation with a 9-item scale. Results In the multiple logistic regression model, perceived stress (aOR = 1.60, 95% CI = 1.32 to 1.95), neighborhood disorder (aOR= 1.34, 95% CI = 1.11 to 1.63), and level of nicotine dependence (aOR = 1.97), 95% CI = 1.62 to 2.40) were all strongly associated with barriers to cessation. Conclusion The results of this study suggest that neighborhood disorder may lead to barriers to cessation among low-income populations. The findings also indicate that tobacco control interventions should examine and address social and physical aspects of impoverished neighborhoods. Implications In many countries, tobacco control programs and policies have been less effective among low-income populations as compared to more affluent populations. Little is known about how neighborhood factors influence smoking cessation. This study examined the relationship between neighborhood disorder and barriers to cessation among a low-income population. We recruited a convenience sample of hard-to-reach cigarette smokers from low-income neighborhoods. Even after controlling for level of nicotine dependence and stress, neighborhood disorder was found to be associated with barriers to cessation. The findings suggest the important role of neighborhood disorder as a barrier to smoking cessation.
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Affiliation(s)
- Carl A Latkin
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Ryan D Kennedy
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Melissa A Davey-Rothwell
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Tuo-Yen Tseng
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Lauren Czaplicki
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Anirudh Baddela
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Catie Edwards
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Geetanjali Chander
- Division of Infectious diseases, Johns Hopkins School of Medicine, Baltimore, MD
| | - Meghan B Moran
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Amy R Knowlton
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
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Carroll SJ, Dale MJ, Bailie R, Daniel M. Climatic and community sociodemographic factors associated with remote Indigenous Australian smoking rates: an ecological study of health audit data. BMJ Open 2019; 9:e032173. [PMID: 31292187 PMCID: PMC6624038 DOI: 10.1136/bmjopen-2019-032173] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
UNLABELLED Australian Indigenous smoking rates are highest in remote communities but likely vary between communities; few studies have assessed community features in relation to Indigenous smoking rates. DESIGN AND OBJECTIVE This ecological study evaluated the associations between smoking rates, and community sociodemographic and climatic characteristics for a large sample of remote Indigenous communities. SETTING AND SAMPLE Records (n=2689) from an audit of community health centres in the Northern Territory and Queensland were used to estimate smoking rates dichotomised at the median for 70 predominantly Indigenous remote communities. Community characteristics were similarly dichotomised. METHODS Cross-tabulations were used to calculate the odds of a community classified as high for a sociodemographic or climatic factor also being high for smoking rate. Additional cross-tabulations, stratified by sociodemographic, region (coastal or central) and geographic connectivity levels, were performed to assess potential confounding. RESULTS Community smoking rates ranged from 25% to 96% (median 60.2%). Moderately strong relationships were observed between community smoking rate and population size (OR 6.25,(95% CI 2.18 to 17.95)), education level (OR 3.67 (1.35-10.01)), income (2.86 (11.07-7.67)) and heat (2.86 (1.07-7.67)). CONCLUSIONS Smoking rates in Australian remote Indigenous communities are universally high. Smoking rates are associated with greater community-level socioeconomic status and size, most likely reflecting greater means of accessing tobacco with mass of smokers sufficient to sustain a normative influence. Severe heat was also associated with high smoking rates suggesting such a stressor might support smoking as a coping mechanism. Community sociodemographic and climatic factors bear consideration as context-level correlates of community smoking rates.
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Affiliation(s)
- Suzanne Jane Carroll
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Michael J Dale
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Mark Daniel
- Centre for Research and Action in Public Health, Health Research Institute, University of Canberra, Canberra, Australian Capital Territory, Australia
- Department of Medicine, St. Vincent’s Hospital, The University of Melbourne, Fitzroy, Victoria, Australia
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Caraballo RS, Rice KL, Neff LJ, Garrett BE. Social and Physical Environmental Characteristics Associated With Adult Current Cigarette Smoking. Prev Chronic Dis 2019; 16:E71. [PMID: 31172916 PMCID: PMC6583817 DOI: 10.5888/pcd16.180373] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Our objective was to identify social and physical environmental factors associated with current cigarette smoking among adults by metropolitan county in the United States. METHODS We linked cigarette smoking data from the 2012 Behavioral Risk Factor Surveillance System (BRFSS) Selected Metropolitan Area Risk Trends (SMART) data set to 7 social and physical environmental characteristics: county type (metropolitan designation), primary care physician density, income inequality, percentage of the population that was a racial/ethnic minority, violent crime rate, education, and percentage of county residents with low income and no health insurance, all obtained from several county data sets. Spatial regression and hierarchical logistic regression modeling were performed. RESULTS Results showed that metropolitan counties with a high proportion of non-Hispanic white adults (P < .001), lower education levels (high school graduate or less) (P < .001), and high violent crime rates (P < .001) had a higher adult cigarette smoking prevalence than other metropolitan counties. Spatial models showed 63.3% of the variability in county cigarette smoking prevalence was explained by these 3 factors as well as county type (based on population size of the of metropolitan area), primary care physician density, and percentage of county residents with low income and no health insurance. At an individual level, results showed that as the density (population) of primary care physicians increased in a county, the odds of being a current smoker decreased (OR, 0.980; P = .02). CONCLUSION We found a significant association between adult cigarette smoking and county social and physical environmental factors. These place-based factors, especially social environmental characteristics, may reveal tobacco-related disparities to be considered when developing strategies to reduce tobacco use.
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Affiliation(s)
- Ralph S Caraballo
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Hwy, NE, MS S107-7, Atlanta, 30341-3717.
| | - Ketra L Rice
- National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Linda J Neff
- National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Bridgette E Garrett
- National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Jennings V, Bamkole O. The Relationship between Social Cohesion and Urban Green Space: An Avenue for Health Promotion. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16030452. [PMID: 30720732 PMCID: PMC6388234 DOI: 10.3390/ijerph16030452] [Citation(s) in RCA: 199] [Impact Index Per Article: 39.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 01/28/2019] [Accepted: 01/29/2019] [Indexed: 11/16/2022]
Abstract
Social cohesion involves the interpersonal dynamics and sense of connection among people. Increased social cohesion can be associated with various physical and psychological health benefits. The presence of urban green spaces can encourage positive social interactions that cultivate social cohesion in ways that enhance health and well-being. Urban green spaces have also been linked to positive health behaviors and outcomes including increased physical activity and social engagement. Understanding the relationship between social cohesion and urban green space is important for informing holistic approaches to health. In this article, we discuss how positive interactions in urban green space can catalyze social cohesion, social capital and critical health-promoting behaviors that may enhance psychological health and well-being. We also summarize the strengths and limitations of previous studies and suggest directions for future research.
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Affiliation(s)
- Viniece Jennings
- Southern Research Station, Integrating Human and Natural Systems, USDA Forest Service, 320 Green Street, Athens, GA 30602, USA.
| | - Omoshalewa Bamkole
- Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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O'Brien DT, Farrell C, Welsh BC. Broken (windows) theory: A meta-analysis of the evidence for the pathways from neighborhood disorder to resident health outcomes and behaviors. Soc Sci Med 2018; 228:272-292. [PMID: 30885673 DOI: 10.1016/j.socscimed.2018.11.015] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/12/2018] [Accepted: 11/07/2018] [Indexed: 01/01/2023]
Abstract
The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.
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Affiliation(s)
- Daniel T O'Brien
- School of Public Policy & Urban Affairs, Northeastern University, Boston Area Research Initiative, Northeastern & Harvard Universities, USA.
| | - Chelsea Farrell
- School of Criminology & Criminal Justice, Northeastern University, USA
| | - Brandon C Welsh
- School of Criminology & Criminal Justice, Northeastern University, USA
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18
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An American Thoracic Society/National Heart, Lung, and Blood Institute Workshop Report: Addressing Respiratory Health Equality in the United States. Ann Am Thorac Soc 2018; 14:814-826. [PMID: 28459618 DOI: 10.1513/annalsats.201702-167ws] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Health disparities related to race, ethnicity, and socioeconomic status persist and are commonly encountered by practitioners of pediatric and adult pulmonary, critical care, and sleep medicine in the United States. To address such disparities and thus progress toward equality in respiratory health, the American Thoracic Society and the National Heart, Lung, and Blood Institute convened a workshop in May of 2015. The workshop participants addressed health disparities by focusing on six topics, each of which concluded with a panel discussion that proposed recommendations for research on racial, ethnic, and socioeconomic disparities in pulmonary, critical care, and sleep medicine. Such recommendations address best practices to advance research on respiratory health disparities (e.g., characterize broad ethnic groups into subgroups known to differ with regard to a disease of interest), risk factors for respiratory health disparities (e.g., study the impact of new tobacco or nicotine products on respiratory diseases in minority populations), addressing equity in access to healthcare and quality of care (e.g., conduct longitudinal studies of the impact of the Affordable Care Act on respiratory and sleep disorders), the impact of personalized medicine on disparities research (e.g., implement large studies of pharmacogenetics in minority populations), improving design and methodology for research studies in respiratory health disparities (e.g., use study designs that reduce participants' burden and foster trust by engaging participants as decision-makers), and achieving equity in the pulmonary, critical care, and sleep medicine workforce (e.g., develop and maintain robust mentoring programs for junior faculty, including local and external mentors). Addressing these research needs should advance efforts to reduce, and potentially eliminate, respiratory, sleep, and critical care disparities in the United States.
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Nemeth JM, Thomson TL, Lu B, Peng J, Krebs V, Doogan NJ, Ferketich AK, Post DM, Browning CR, Paskett ED, Wewers ME. A social-contextual investigation of smoking among rural women: multi-level factors associated with smoking status and considerations for cessation. Rural Remote Health 2018; 18:4338. [PMID: 29500916 DOI: 10.22605/rrh4338] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION The social-contextual model of tobacco control and the potential mechanisms of the maintenance or cessation of smoking behavior among disadvantaged women, including rural residents, have yet to be comprehensively studied. The purpose of this study was to determine the association between selected individual, interpersonal, workplace, and neighborhood characteristics and smoking status among women in Appalachia, a US region whose residents experience a disproportionate prevalence of tobacco-related health disparities. These findings may assist in efforts to design and test scientifically valid tobacco control interventions for this and other disadvantaged populations. METHODS Women, 18 years of age and older, residing in three rural Ohio Appalachian counties, were recruited using a two-phase address-based sampling methodology for a cross-sectional interview-administered survey between August 2012 and October 2013 (N=408). Multinomial logistic regression was employed to determine associations between select multilevel factors (independent variables) and smoking status (dependent variable). The sample included 82 (20.1%) current smokers, 92 (22.5%) former smokers, and 234 (57.4%) women reporting never smoking (mean age 51.7 years). RESULTS In the final multivariable multinomial logistic regression model, controlling for all other significant associations, constructs at multiple social-contextual levels were associated with current versus either former or never smoking. At the individual level, for every additional year in age, the odds of being a former or never smoker increased by 7% and 6% (odds ratio (OR) (95% confidence interval(CI)): 1.07 (1.0-1.11) and 1.06 (1.02-1.09)), respectively, as compared to the odds of being a current smoker. With regard to depression, for each one unit increase in the Center for Epidemiologic Studies Depression Scale score, the odds of being a former or never smoker were 5% and 7% lower (OR(95%CI): 0.95(0.91-0.999) and 0.93(0.88-0.98)), respectively. Five interpersonal factors were associated with smoking status. As the social influence injunctive norm score increased by one unit, indicating perception of smoking to be more acceptable, the odds of being a former or never smoker decreased by 23% and 30%, respectively. For every one unit increase in the social participation score, indicating past-year engagement in one additional activity type, the odds of being a former or never smoker increased by 17% and 36%, respectively. For every 10% increase in the percentage of social ties in the participant's advice network who smoked, the odds of being a former or never smoker were 24% and 28% less, respectively. For every 0.1 unit increase in the E/I index, indicating increasing homophily on smoking in one's social network, the odds of being a former or never smoker were 20% and 24% less, respectively, in the time network, and 18% and 20% less, respectively, in the advice network. At the neighborhood level, for every one unit increase in neighborhood cohesion score, indicating increasing cohesion, the odds of being a former smoker or never smoker were 12% and 14% less, respectively. CONCLUSIONS These findings indicate that a social-contextual approach to tobacco control may be useful for narrowing a widening trajectory of smoking disparity for rural women. Interpersonal context, in particular, must be considered in the development of culturally targeted cessation interventions for Ohio Appalachian women.
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Affiliation(s)
- Julianna M Nemeth
- The Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
| | - Tiffany L Thomson
- The Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
| | - Bo Lu
- The Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
| | - Juan Peng
- The Ohio State University Center for Biostatistics, Lincoln Tower, Columbus, OH, USA
| | | | - Nathan J Doogan
- The Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
| | - Amy K Ferketich
- The OhiThe Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
| | - Douglas M Post
- The Ohio State University College of Medicine, Columbus, OH, USA
| | | | - Electra D Paskett
- The Ohio State University College of Medicine, Columbus, OH, USA and The Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
| | - Mary E Wewers
- The Ohio State University College of Public Health, Cunz Hall, Columbus, OH, USA
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Urban Green Space and the Pursuit of Health Equity in Parts of the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111432. [PMID: 29165367 PMCID: PMC5708071 DOI: 10.3390/ijerph14111432] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 11/13/2017] [Accepted: 11/16/2017] [Indexed: 12/29/2022]
Abstract
Research has demonstrated that inequitable access to green space can relate to health disparities or inequalities. This commentary aims to shift the dialogue to initiatives that have integrated green spaces in projects that may promote health equity in the United States. Specifically, we connect this topic to factors such as community revitalization, affordable housing, neighborhood walkability, food security, job creation, and youth engagement. We provide a synopsis of locations and initiatives in different phases of development along with characteristics to support effectiveness and strategies to overcome challenges. The projects cover locations such as Atlanta (GA), Los Angeles (CA), the District of Columbia (Washington D.C.), South Bronx (NY), and Utica (NY). Such insight can develop our understanding of green space projects that support health equity and inform the dialogue on this topic in ways that advance research and advocacy.
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Haley DF, Linton S, Luo R, Hunter-Jones J, Adimora AA, Wingood GM, Bonney L, Ross Z, Cooper HL. Public Housing Relocations and Relationships of Changes in Neighborhood Disadvantage and Transportation Access to Unmet Need for Medical Care. J Health Care Poor Underserved 2017; 28:315-328. [PMID: 28239005 PMCID: PMC5501981 DOI: 10.1353/hpu.2017.0026] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Cross-sectional research suggests that neighborhood characteristics and transportation access shape unmet need for medical care. This longitudinal analysis explores relationships of changes in neighborhood socioeconomic disadvantage and trans- portation access to unmet need for medical care. METHODS We analyzed seven waves of data from African American adults (N = 172) relocating from severely distressed public housing complexes in Atlanta, Georgia. Surveys yielded individual-level data and admin- istrative data characterized census tracts. We used hierarchical generalized linear models to explore relationships. RESULTS Unmet need declined from 25% pre-relocation to 12% at Wave 7. Post-relocation reductions in neighborhood disadvantage were inversely associated with reductions in unmet need over time (OR = 0.71, 95% CI = 0.51-0.99). More frequent transportation barriers predicted unmet need (OR = 1.16, 95% CI = 1.02-1.31). CONCLUSION These longitudinal findings support the importance of neighborhood environments and transportation access in shaping unmet need and suggest that improvements in these exposures reduce unmet need for medical care in this vulnerable population.
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Mayne SL, Auchincloss AH, Moore KA, Michael YL, Tabb LP, Echeverria SE, Diez Roux AV. Cross-sectional and longitudinal associations of neighbourhood social environment and smoking behaviour: the multiethnic study of atherosclerosis. J Epidemiol Community Health 2016; 71:396-403. [PMID: 27885050 DOI: 10.1136/jech-2016-207990] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/18/2016] [Accepted: 11/07/2016] [Indexed: 11/03/2022]
Abstract
BACKGROUND Social features of neighbourhood environments may influence smoking by creating a stressful environment or by buffering stress through social cohesion. However, the association of the overall neighbourhood social environment (NSE) with smoking, and the association of specific neighbourhood social factors with change in smoking behaviour over time, has rarely been examined. METHODS This study included 5856 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis (2000-2012, average follow-up: 7.8 years). Outcomes included current smoking status and smoking intensity (average number of cigarettes smoked per day among baseline smokers). NSE was assessed as a composite score composed of aesthetic quality, safety and social cohesion scales (derived from neighbourhood surveys). Generalised linear mixed models evaluated the association of baseline NSE (composite score and individual scales) with current smoking (modified Poisson models) and smoking intensity (negative binomial models) cross-sectionally and longitudinally. RESULTS Each SD increase in baseline NSE composite score was associated with 13% lower prevalence of smoking at baseline (adjusted prevalence ratio (aPR) 0.87 (95% CI 0.78 to 0.98). Neighbourhood safety and aesthetic quality were similarly associated with lower smoking prevalence (aPR 0.87 (0.78 to 0.97) and aPR 0.87 (0.77 to 0.99), respectively) but the association with social cohesion was weaker or null. No significant associations were observed for smoking intensity among baseline smokers. Baseline NSE was not associated with changes in smoking risk or intensity over time. CONCLUSIONS Results suggest that neighbourhood social context influences whether older adults smoke, but does not promote smoking cessation or reduction over time.
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Affiliation(s)
- Stephanie L Mayne
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Amy H Auchincloss
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Loni Philip Tabb
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Sandra E Echeverria
- Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, New York, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
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Simmons VN, Pineiro B, Hooper MW, Gray JE, Brandon TH. Tobacco-Related Health Disparities Across the Cancer Care Continuum. Cancer Control 2016; 23:434-441. [PMID: 27842333 PMCID: PMC5972388 DOI: 10.1177/107327481602300415] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Use of tobacco is the leading preventable cause of death in the United States. Racial/ethnic minorities and individuals of low socioeconomic status disproportionately experience tobacco-related disease and illness. Unique challenges and circumstances exist at each point in the cancer care continuum that may contribute to the greater cancer burden experienced by these groups. METHODS We reviewed tobacco-related disparities from cancer prevention to cancer survivorship. We also describe research that seeks to reduce tobacco-related disparities. RESULTS Racial/ethnic minorities and low-income individuals experience unique social and environmental contextual challenges such as greater environmental cues to smoke and greater levels of perceived stress and social discrimination. Clinical practice guidelines support the effectiveness of pharmacotherapy and behavioral counseling for racial and ethnic minorities, yet smoking cessation rates are lower in this group when compared with non-Hispanic whites. Superior efficacy for culturally adapted interventions has not yet been established. CONCLUSIONS To reduce health disparities in this population, a comprehensive strategy is needed with efforts directed at each point along the cancer care continuum. Strategies are needed to reduce the impact of contextual factors such as targeted tobacco marketing and social discrimination on smoking initiation and maintenance. Future efforts should focus on increasing the use of evidence-based cessation treatment methods and studying its effectiveness in these populations. Attention must also be focused on improving treatment outcomes by reducing smoking in diverse racial and ethnic patient populations.
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Affiliation(s)
- Vani Nath Simmons
- Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA.
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Andrews JO, Mueller M, Dooley M, Newman SD, Magwood GS, Tingen MS. Effect of a smoking cessation intervention for women in subsidized neighborhoods: A randomized controlled trial. Prev Med 2016; 90:170-6. [PMID: 27423320 PMCID: PMC5871346 DOI: 10.1016/j.ypmed.2016.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 05/16/2016] [Accepted: 07/08/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of a community based participatory research (CBPR) developed, multi-level smoking cessation intervention among women in subsidized housing neighborhoods in the Southeastern US. METHODS A total of n=409 women in 14 subsidized housing neighborhoods in Georgia and South Carolina participated in this group randomized controlled trial conducted from 2009 to 2013. Intervention neighborhoods received a 24-week intervention with 1:1 community health worker contact, behavioral peer group sessions, and nicotine replacement. Control neighborhoods received written cessation materials at weeks 1, 6, 12, 18. Random coefficient models were used to compare smoking abstinence outcomes at 6 and 12months. Significance was set a p<0.05. RESULTS The majority of participants (91.2%) were retained during the 12-month intervention period. Smoking abstinence rates at 12months for intervention vs. control were 9% vs. 4.3%, p=0.05. Additional analyses accounting for passive smoke exposure in these multi-unit housing settings demonstrated 12month abstinence rates of 12% vs. 5.3%, p=0.016. However, in the multivariate regression analyses, there was no significant effect of the intervention on the odds of being a non-smoker (OR=0.44, 95% CI: 0.18-1.07). Intervention participants who kept coach visits, attended group sessions, and used patches were more likely to remain abstinent. CONCLUSIONS This CBPR developed intervention showed potential to engage smokers and reduce smoking among women in these high-poverty neighborhoods. Effectiveness in promoting cessation in communities burdened with fiscal, environmental and social inequities remains a public health priority.
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Affiliation(s)
- Jeannette O Andrews
- University of South Carolina, College of Nursing, 1601 Greene Street, Columbia, SC 29208, USA.
| | - Martina Mueller
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425-1600, USA
| | - Mary Dooley
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425-1600, USA
| | - Susan D Newman
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425-1600, USA
| | - Gayenell S Magwood
- Medical University of South Carolina, College of Nursing, 99 Jonathan Lucas St., MSC 160, Charleston, SC 29425-1600, USA
| | - Martha S Tingen
- Augusta University, Medical College of Georgia, 1120 Fifteenth Street, HS-1755, Augusta, GA 30912, USA
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Arcaya MC, Tucker-Seeley RD, Kim R, Schnake-Mahl A, So M, Subramanian SV. Research on neighborhood effects on health in the United States: A systematic review of study characteristics. Soc Sci Med 2016; 168:16-29. [PMID: 27637089 DOI: 10.1016/j.socscimed.2016.08.047] [Citation(s) in RCA: 239] [Impact Index Per Article: 29.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 08/17/2016] [Accepted: 08/27/2016] [Indexed: 10/21/2022]
Abstract
Neighborhood effects on health research has grown over the past 20 years. While the substantive findings of this literature have been published in systematic reviews, meta-analyses, and commentaries, operational details of the research have been understudied. We identified 7140 multi-level neighborhoods and health papers published on US populations between 1995 and 2014, and present data on the study characteristics of the 256 papers that met our inclusion criteria. Our results reveal rapid growth in neighborhoods and health research in the mid-2000s, illustrate the dominance of observational cross-sectional study designs, and show a heavy reliance on single-level, census-based neighborhood definitions. Socioeconomic indicators were the most commonly analyzed neighborhood variables and body mass was the most commonly studied health outcome. Well-known challenges associated with neighborhood effects research were infrequently acknowledged. We discuss how these results move the agenda forward for neighborhoods and health research.
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Affiliation(s)
| | | | - Rockli Kim
- Harvard Chan School of Public Health, USA
| | | | - Marvin So
- Harvard Chan School of Public Health, USA
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Rachele JN, Wood L, Nathan A, Giskes K, Turrell G. Neighbourhood disadvantage and smoking: Examining the role of neighbourhood-level psychosocial characteristics. Health Place 2016; 40:98-105. [PMID: 27228312 DOI: 10.1016/j.healthplace.2016.04.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 04/22/2016] [Accepted: 04/25/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE This study aims to determine if neighbourhood psychosocial characteristics contribute to inequalities in smoking among residents from neighbourhoods of differing socioeconomic disadvantage. METHODS This cross-sectional study includes 11,035 residents from 200 neighbourhoods in Brisbane, Australia in 2007. Self-reported measures were obtained for smoking and neighbourhood psychosocial characteristics (perceptions of incivilities, crime and safety, and social cohesion). Neighbourhood socioeconomic disadvantage was measured using a census-derived index. Data were analysed using multilevel logistic regression random intercept models. RESULTS Smoking was associated with neighbourhood disadvantage; this relationship remained after adjustment for individual-level socioeconomic position. Area-level perceptions of crime and safety and social cohesion were not independently associated with smoking, and did not explain the higher prevalence of smoking in disadvantaged areas; however, perceptions of incivilities showed an independent effect. CONCLUSIONS Some neighbourhood psychosocial characteristics seem to contribute to the higher rates of smoking in disadvantaged areas.
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Affiliation(s)
- Jerome N Rachele
- Institute for Health and Ageing, Australian Catholic University, Australia; School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; School of Population and Global Health, University of Melbourne, Australia.
| | - Lisa Wood
- School of Population Health, University of Western Australia, Perth, Australia.
| | - Andrea Nathan
- Institute for Health and Ageing, Australian Catholic University, Australia; School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia.
| | - Katrina Giskes
- Faculty of Medicine, University of Sydney, Sydney, Australia.
| | - Gavin Turrell
- Institute for Health and Ageing, Australian Catholic University, Australia; School of Public Health and Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Australia; School of Population and Global Health, University of Melbourne, Australia.
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Kulak JA, Cornelius ME, Fong GT, Giovino GA. Differences in Quit Attempts and Cigarette Smoking Abstinence Between Whites and African Americans in the United States: Literature Review and Results From the International Tobacco Control US Survey. Nicotine Tob Res 2016; 18 Suppl 1:S79-87. [PMID: 26980868 PMCID: PMC5009448 DOI: 10.1093/ntr/ntv228] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 09/30/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION While cigarette smoking prevalence is declining among US adults, quit rates may differ between white and African American smokers. Here, we summarize the literature on smoking cessation behaviors in whites and African Americans across four study designs and report the findings of new analyses of International Tobacco Control (ITC) US Survey cohort data. METHODS We reviewed 32 publications containing 39 relevant analyses that compared quit attempts and abstinence between US whites and African Americans. Two additional longitudinal analyses were conducted on 821 white and 76 African American cigarette smokers from Waves 7 and 8 of the ITC US Survey (mean follow-up = 19 months). RESULTS Of 17 total analyses of quit attempts, nine (including the ITC US Survey) observed that African American smokers were more likely than whites to attempt to quit during a given year; seven found no differences. Whites were more likely than African Americans to be abstinent in five of six retrospective cohort analyses and in two of five considered community- and population-based cohort studies. Four of these 11 analyses, including one from the ITC US Survey, found no differences. CONCLUSIONS Of 11 population- or community-based analyses, all seven that found significant differences indicated that whites were more likely to quit than African Americans. These findings, combined with the similar results from population-based birth cohort analyses, support the conclusion that white smokers are more likely to quit than African American smokers. Efforts to encourage and support quitting among all tobacco users remain a priority. IMPLICATIONS This article provides a review of the literature on smoking cessation among African American and white smokers, and adds new analyses that compare quit attempts and abstinence between US African Americans and whites. Results demonstrate a clear distinction between the findings of cross-sectional and retrospective cohort studies with those of cohort studies. Reasons for these differences merit further study.
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Affiliation(s)
- Jessica A Kulak
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY;
| | - Monica E Cornelius
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC
| | - Geoffrey T Fong
- Department of Psychology and School of Public Health and Health Systems, University of Waterloo, Waterloo, ON, Canada; Ontario Institute for Cancer Research, Toronto, ON, Canada
| | - Gary A Giovino
- Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY
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Achuko O, Walker RJ, Campbell JA, Dawson AZ, Egede LE. Pathways Between Discrimination and Quality of Life in Patients with Type 2 Diabetes. Diabetes Technol Ther 2016; 18:151-8. [PMID: 26866351 PMCID: PMC4790216 DOI: 10.1089/dia.2015.0305] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Discrimination is a social determinant that has been linked to poor physical and mental health outcomes. This study aimed to examine the pathway whereby discrimination influences quality of life in patients with type 2 diabetes. SUBJECTS AND METHODS Six hundred fifteen patients were recruited from two adult primary care clinics in the southeastern United States. Measures included perceived discrimination, perceived stress, social support, and social cohesion and were based on a theoretical model for the pathways by which perceived discrimination influences mental and physical health. Quality of life was measured using the SF-12 questionnaire. RESULTS The final model [χ(2)(106) = 157.35, P = 0.009, R(2) = 0.99, root mean square error of approximation = 0.03, comparative fit index = 0.99] indicates direct effects of higher perceived stress (r = -1.02, P < 0.05) and lower social support (r = 0.36, P < 0.001) significantly related to decreased mental health component score (MCS) of quality of life. Discrimination and social cohesion were not significantly directly related to MCS. However, higher discrimination (r = 0.47, P < 0.001), higher social cohesion (r = 0.14, P < 0.05), and lower social support (r = -0.43, P < 0.001) were significantly directly related to increased stress. No significant paths were found for the physical component score of quality of life. CONCLUSIONS Perceived discrimination was significantly associated with stress and served as a pathway to influence the mental health component of quality of life (MCS). Social support had a direct and an indirect effect on MCS through a negative association with stress. These results suggest that future interventions should be developed to decrease stress and increase social support surrounding discrimination to improve the MCS of quality of life in patients with diabetes.
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Affiliation(s)
- Obinna Achuko
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina
| | - Rebekah J. Walker
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina
- Health Equity and Rural Outreach Innovation Center, Charleston VA Health Services Research and Development COIN, Ralph H. Johnson VA Medical Center, Charleston, South Carolina
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Jennifer A. Campbell
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina
| | - Aprill Z. Dawson
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina
| | - Leonard E. Egede
- Center for Health Disparities Research, Medical University of South Carolina, Charleston, South Carolina
- Health Equity and Rural Outreach Innovation Center, Charleston VA Health Services Research and Development COIN, Ralph H. Johnson VA Medical Center, Charleston, South Carolina
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina
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Jennings V, Larson L, Yun J. Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:196. [PMID: 26861365 PMCID: PMC4772216 DOI: 10.3390/ijerph13020196] [Citation(s) in RCA: 209] [Impact Index Per Article: 26.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 01/25/2016] [Accepted: 02/02/2016] [Indexed: 02/01/2023]
Abstract
Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice.
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Affiliation(s)
- Viniece Jennings
- Southern Research Station, Integrating Human and Natural Systems, USDA Forest Service, 320 Green Street, Athens, GA 30602, USA.
| | - Lincoln Larson
- Department of Parks, Recreation, and Tourism Management, Clemson University, Clemson, SC 29634, USA.
| | - Jessica Yun
- Department of Science, Technology and International Affairs, Georgetown University, Washington, DC 20057, USA.
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Alcalá HE, Sharif MZ, Albert SL. Social cohesion and the smoking behaviors of adults living with children. Addict Behav 2016; 53:201-5. [PMID: 26562680 DOI: 10.1016/j.addbeh.2015.10.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 10/29/2015] [Accepted: 10/30/2015] [Indexed: 11/11/2022]
Abstract
INTRODUCTION The smoking behavior of adults can negatively impact children through exposure to environmental tobacco smoke and by modeling this unhealthy behavior. Little research has examined the role of the social environment in smoking behaviors of adults living with children. The present study specifically analyzed the relationship between social cohesion and smoking behaviors of adults living with children. METHODS Data from the 2009 California Health Interview Survey, a random-digit dial cross-sectional survey of California Adults, were used. Adults living with children reported their levels of social cohesion and smoking behaviors (N=13,978). Logistic regression models were used to predict odds of being a current smoker or living in a household in which smoking was allowed, from social cohesion. RESULTS Overall, 13% of the sample was current smokers and 3.74% lived in households in which smoking was allowed. Logistic regression models showed that each one-unit increase in social cohesion is associated with reduced odds of being a current smoker (AOR=0.92; 95% CI=0.85-0.99) and reduced odds of living in a household in which smoking is allowed (AOR=0.84; 95% CI=0.75-0.93), after controlling for sociodemographic characteristics. CONCLUSIONS Among adults living with children, higher social cohesion is associated with a lower likelihood of both being and smoker and living in a home where smoking is allowed. Thus, future research is needed to better understand mechanisms that explain the relationship between social cohesion and smoking-related behavior in order to prevent smoking-related health consequences and smoking initiation among children and adults.
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Marcus AF, Echeverria SE, Holland BK, Abraido-Lanza AF, Passannante MR. How Neighborhood Poverty Structures Types and Levels of Social Integration. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2015; 56:134-144. [PMID: 26076667 DOI: 10.1007/s10464-015-9732-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Social integration is fundamental to health and well-being. However, few studies have explored how neighborhood contexts pattern types and levels of social integration that individuals experience. We examined how neighborhood poverty structures two dimensions of social integration: integration with neighbors and social integration more generally. Using data from the United States Third National Health and Nutrition Examination Survey, we linked study participants to percent poverty in their neighborhood of residence (N = 16,040). Social integration was assessed using a modified Social Network Index and neighborhood integration based on yearly visits with neighbors. We fit multivariate logistic regression models that accounted for the complex survey design. Living in high poverty neighborhoods was associated with lower social integration but higher visits with neighbors. Neighborhood poverty distinctly patterns social integration, demonstrating that contexts shape the extent and quality of social relationships.
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Affiliation(s)
- Andrea Fleisch Marcus
- Department of Nutritional Sciences, Rutgers School of Health Related Professions, 65 Bergen Street, Room 157, Newark, NJ, 07107, USA,
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