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Adams EL, Estradé M, Lewis EC, Poirier-Barna L, Smith MT, Gittelsohn J. Perceptions around sleep hygiene practices and beliefs among urban Black adolescents and their caregivers during the COVID-19 pandemic. Sleep Health 2024:S2352-7218(24)00168-2. [PMID: 39332925 DOI: 10.1016/j.sleh.2024.07.009] [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: 02/10/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 09/29/2024]
Abstract
OBJECTIVE This study gathered adolescent and caregiver perspectives on sleep hygiene practices and beliefs for Black families living in low-resourced urban communities. METHODS Semistructured interviews were conducted with adolescents (n = 9) and caregivers (n = 9) from January-March 2021, during the COVID-19 pandemic. Interview questions included adolescent's current sleep habits, barriers, and home and neighborhood influences. Trained researchers coded data using inductive analysis and a constant comparative method to derive themes. RESULTS Two themes focused on sleep hygiene practices, including items used to facilitate sleep (e.g., melatonin, electronics) and COVID-19 consequences on sleep schedules. Two themes focused on sleep hygiene beliefs, including a common value on the importance of sleep and influences on caregiver's bedtime rules. CONCLUSIONS Findings provide important insights on sleep hygiene practices and beliefs in a historically marginalized population of Black adolescents and caregivers in urban communities to inform targeted sleep interventions, policies, and programs for optimal sleep and well-being.
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Affiliation(s)
- Elizabeth L Adams
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina, United States; Research Center for Child Well-Being, University of South Carolina, Columbia, South Carolina, United States
| | - Michelle Estradé
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Emma C Lewis
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Lisa Poirier-Barna
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Michael T Smith
- Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Joel Gittelsohn
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, United States.
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Hua S, Vong V, Thomas AE, Mui Y, Poirier L. Barriers and Enablers for Equitable Healthy Food Access in Baltimore Carryout Restaurants: A Qualitative Study in Healthy Food Priority Areas. Nutrients 2024; 16:3028. [PMID: 39275343 PMCID: PMC11396806 DOI: 10.3390/nu16173028] [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: 08/23/2024] [Revised: 09/05/2024] [Accepted: 09/06/2024] [Indexed: 09/16/2024] Open
Abstract
Black neighborhoods in the U.S., historically subjected to redlining, face inequitable access to resources necessary for health, including healthy food options. This study aims to identify the enablers and barriers to promoting equitable healthy food access in small, independently owned carryout restaurants in under-resourced neighborhoods to address health disparities. Thirteen in-depth interviews were conducted with restaurant owners in purposively sampled neighborhoods within Healthy Food Priority Areas (HFPAs) from March to August 2023. The qualitative data were analyzed using inductive coding and thematic analysis with Taguette software (Version 1.4.1). Four key thematic domains emerged: interpersonal, sociocultural, business, and policy drivers. Owners expressed mixed perspectives on customers' preferences for healthy food, with some perceiving a community desire for healthier options, while others did not. Owners' care for the community and their multicultural backgrounds were identified as potential enablers for tailoring culturally diverse menus to meet the dietary needs and preferences of their clientele. Conversely, profit motives and cost-related considerations were identified as barriers to purchasing and promoting healthy food. Additionally, owners voiced concerns about taxation, policy and regulation, information access challenges, and investment disparities affecting small business operations in HFPAs. Small restaurant businesses in under-resourced neighborhoods face both opportunities and challenges in enhancing community health and well-being. Interventions and policies should be culturally sensitive, provide funding, and offer clearer guidance to help these businesses overcome barriers and access resources needed for an equitable, healthy food environment.
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Affiliation(s)
- Shuxian Hua
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Vicky Vong
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Audrey E Thomas
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Yeeli Mui
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Lisa Poirier
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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Ares G, Turra S, Bonilla L, Costa M, Verdier S, Brunet G, Alcaire F, Curutchet MR, Vidal L. WEIRD and non-consensual food deserts and swamps: A scoping review of operational definitions. Health Place 2024; 89:103315. [PMID: 39013213 DOI: 10.1016/j.healthplace.2024.103315] [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: 03/18/2024] [Revised: 07/02/2024] [Accepted: 07/05/2024] [Indexed: 07/18/2024]
Abstract
The aim of the present study was to critically analyze operational definitions of food deserts and food swamps included in empirical studies published in peer-reviewed journals. A scoping review was conducted following the recommendations of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews. A search of the scientific literature was performed on August 2023 to identify empirical studies including operational definitions of food deserts and/or food swamps in three databases: Scopus, PubMed, and Scielo. A total of 932 scientific articles were identified in the three databases, from which 157 articles, published between 2002 and 2023, were included in the review. The included studies were mainly conducted in WEIRD (Western, Educated, Industrilaized, Rich and Democractic) countries. They presented a total of 107 operational definitions of food deserts and 30 operational definitions of food swamps. Large heterogeneity in the operational definitions of food deserts and food swamps was found. Published studies differed in all the elements of the operational definitions analyzed in the present work. Results stress the need for standardization and the development of more objective and multivariate continuous measures of physical food accessibility that reflect the complexity of modern food environments globally. A series of recommendations to advance food environment research are derived.
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Affiliation(s)
- Gastón Ares
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay.
| | - Sergio Turra
- Escuela de Nutrición, Universidad de la República, Av. Ricaldoni S/N, CP 11600, Montevideo, Uruguay
| | - Luciana Bonilla
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - María Costa
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Sofía Verdier
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Gerónimo Brunet
- Espacio Interdisciplinario, Universidad de la República, José Enrique Rodó 1843, CP 11200, Montevideo, Uruguay
| | - Florencia Alcaire
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
| | - María Rosa Curutchet
- Instituto Nacional de Alimentación, Ministerio de Desarrollo Social, Piedras 165, CP 11000, Montevideo, Uruguay
| | - Leticia Vidal
- Sensometrics & Consumer Science, Instituto Polo Tecnológico de Pando, Facultad de Química, Universidad de la República, By Pass de Rutas 8 y 101 s/n, CP 91000, Pando, Uruguay
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Estradé M, Lightner A, Lewis EC, Adams E, Poirier L, Smith MT, Gittelsohn J. Sources of Stress and Coping Strategies Among Urban African American Adolescents: A Qualitative Study of Child and Caregiver Perspectives. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02049-2. [PMID: 38884862 DOI: 10.1007/s40615-024-02049-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/28/2024] [Accepted: 05/31/2024] [Indexed: 06/18/2024]
Abstract
Early adolescence is a critical point for intervention to protect against negative consequences of stress on the developing brain. This study aimed to gather perspectives on stress from adolescents and their caregivers living in under-resourced Baltimore City neighborhoods. Nine African American adolescents and their caregivers (n = 18 total) participated in qualitative interviews exploring neighborhood environments, sources of stress, and coping behaviors. Neighborhood social cohesion was described as a strength of participants' communities, despite concerns about neighborhood safety. Caregivers were highly aware of their child's stressors and coping behaviors. School-related pressure was a prevalent source of stress emphasized by adolescents, along with social stress due to disrupted routines during the COVID-19 pandemic. Adolescents described frequent use of electronics to cope with stress, as well as self-care and relaxation techniques. Themes identified from these data can be used to inform future adolescent stress-reduction interventions and stress-prevention efforts in this priority population.
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Affiliation(s)
- Michelle Estradé
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Alexis Lightner
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Emma C Lewis
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Elizabeth Adams
- Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Lisa Poirier
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael T Smith
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Joel Gittelsohn
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Jiang Q, Ghosh D, Steinbach S, Cooksey Stowers K. A longitudinal assessment of racial and ethnic inequities in food environment exposure and retail market concentration. Public Health Nutr 2023; 26:1850-1861. [PMID: 37326127 PMCID: PMC10478051 DOI: 10.1017/s1368980023001179] [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: 08/06/2022] [Revised: 05/10/2023] [Accepted: 06/05/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVE This paper assesses trends in food environment and market concentration and racial and ethnic inequities in food environment exposure and food retail market concentration at the US census tract level from 2000 to 2019. DESIGN Establishment-level data from the National Establishment Time Series were used to measure food environment exposure and food retail market concentration. We linked that dataset to race, ethnicity and social vulnerability information from the American Community Survey and the Agency for Toxic Substances and Disease Registry. A geospatial hot-spot analysis was conducted to identify relatively low and high healthy food access clusters based on the modified Retail Food Environment Index (mRFEI). The associations were assessed using two-way fixed effects regression models. SETTING Census tracts spanning all US states. PARTICIPANTS 69 904 US census tracts. RESULTS The geospatial analysis revealed clear patterns of areas with high and low mRFEI values. Our empirical findings point to disparities in food environment exposure and market concentration by race. The analysis shows that Asian Americans are likelier to live in neighbourhoods with a low food environment exposure and low retail market concentration. These adverse effects are more pronounced in metro areas. The robustness analysis for the social vulnerability index confirms these results. CONCLUSION US food policies must address disparities in neighbourhood food environments and foster a healthy, profitable, equitable and sustainable food system. Our findings may inform equity-oriented neighbourhood, land use and food systems planning. Identifying priority areas for investment and policy interventions is essential for equity-oriented neighbourhood planning.
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Affiliation(s)
- Qianxia Jiang
- Center for Children’s Healthy Lifestyles and Nutrition, Children’s Mercy Kansas City, Kansas City, MO, USA
| | - Debarchana Ghosh
- Department of Geography, University of Connecticut, Storrs, CT, USA
| | - Sandro Steinbach
- Department of Agricultural and Resource Economics, University of Connecticut, Storrs, CT, USA
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Slipped Capital Femoral Epiphysis, Food Deserts, Poverty, and Urban/Rural Residence: Is There a Link? J Pediatr Orthop 2023; 43:e230-e235. [PMID: 36730127 DOI: 10.1097/bpo.0000000000002315] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Childhood obesity is increased in food deserts, a community with little to no access to healthy food. As obesity is associated with slipped capital femoral epiphysis (SCFE), it was the purpose of this study to analyze the prevalence of SCFE patients by food desert location and its interaction with rural/urban location. METHODS A retrospective review of all consecutive patients with idiopathic SCFE treated at our institution over 11 years was performed. From the patient's address, the US Census Bureau tract in which the patient resided was determined. Using the census tract code, it was ascertained if the patient lived in a food desert and urban or rural location. Standard statistical analyses were performed; a P <0.05 was considered statistically significant. RESULTS There were 177 SCFE patients: 79 girls, 98 boys, 106, White, and 69 nonWhite. The average age at diagnosis was 12.1±1.7 years, the average symptom duration 4.1±5.1 months, and the average weight percentile 94±10. Of these 177 patients, 26.5% lived in a food desert, which was higher than the expected 17.5% ( P =0.023). Those living in a food desert were more commonly nonWhite (60% vs. 32%, P =0.0014). There were 25% from rural areas and 75% from urban areas. No rural SCFE patients lived in food deserts whereas 34% of urban patients lived in food deserts. The average poverty rate of the SCFE patient census tracts was 19%, no greater than the expected 15% ( P =0.32). SCFE patients living in rural census tracts had a lower poverty rate ( P <10 -6 ). CONCLUSIONS There is a correlation with the prevalence of SCFE patients by residence in a "food desert", but not with rural/urban locale or poverty status in Indiana. Further research will be needed to see if these findings apply to other states within the United States and other parts of the world. LEVEL OF EVIDENCE III.
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Singleton CR, Winata F, Adams AM, McLafferty SL, Sheehan KM, Zenk SN. County-level associations between food retailer availability and violent crime rate. BMC Public Health 2022; 22:2002. [PMID: 36320015 PMCID: PMC9628069 DOI: 10.1186/s12889-022-14415-y] [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: 05/19/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Violent crime (i.e., homicide, armed robbery, aggravated assault, and rape) continues to be a major public health concern in America. Several studies have linked the availability and density of specific features of the retail food environment, such as convenience stores and liquor stores, to violent crime rates due to the criminal activity that often occurs in and near these retailers. Nevertheless, there continues to be limited understanding of how other features (e.g., grocery stores, supercenters, restaurants, etc.) are associated with violent crime occurrence. This study aimed to fill this gap in knowledge by examining U.S. county-level associations between food retailer availability and violent crime rate. METHODS We analyzed 2014 data on 3108 counties from the U.S. Department of Agriculture's Food Environment Atlas and Department of Justice's Unified Crime Reporting Program. Per capita food retailer measures represented the number of stores per 10,000 county residents. Violent crime rate represented the number of police reported violent crimes per 10,000 county residents. We used spatial lag regression models to assess associations between per capita retailer availability and violent crime rate after adjusting for potential confounders (e.g., % under 18, % Black, % Hispanic, % poverty, population density, etc.). In addition, we examined stratified OLS regression models to evaluate associations by metropolitan county status. RESULTS Adjusted spatial regression models revealed that greater supercenter availability [β: 2.42; 95% CI: 0.91-3.93; p-value: 0.001] and greater fast food restaurant availability [β: 0.30; 95% CI: 0.18-0.42; p-value: < 0.001] were associated with higher violent crime rate. Greater availability of farmers' markets [β: -0.42; 95% CI: -0.77 - - 0.07); p-value: 0.02] was associated with lower violent crime rate. Associations varied between metropolitan and non-metropolitan counties. Stratified OLS models revealed that greater grocery store availability was associated with lower violent crime rate among metropolitan counties only. Greater fast food restaurant availability was associated with lower violent crime rate among non-metropolitan counties only. CONCLUSIONS Certain features of the retail food environment appear to be associated with county-level violent crime rates in America. These findings highlight the need for additional research on the influence of food retail and food landscape on violent crime occurrence at the community level.
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Affiliation(s)
- Chelsea R Singleton
- Department of Social, Behavioral, and Population Sciences, Tulane School of Public Health & Tropical Medicine, 1440 Canal St., Suite 2200-20, New Orleans, LA, 70112, USA.
| | - Fikriyah Winata
- Department of Geosciences, Mississippi State University, 355 Lee Blvd, 108 Hilbun Hall, Starkville, MS, 39762, USA
| | - Ashley M Adams
- Department of Kinesiology and Community Health, College of Applied Health Sciences University of Illinois Urbana-Champaign, 1206 S Fourth St., Champaign, IL, 61820, USA
| | - Sara L McLafferty
- Department of Geography and Geographic Information Science, University of Illinois Urbana-Champaign, 1301 W Green St., Urbana, IL, 61801, USA
| | - Karen M Sheehan
- Departments of Pediatrics, Medical Education, and Preventive Medicine, Northwestern University, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave., Chicago, IL, 60611, USA
| | - Shannon N Zenk
- National Institute of Nursing Research, National Institutes of Health, 31 Center Dr., Bethesda, MD, 20892, USA
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Addressing Food Insecurity through a Health Equity Lens: a Case Study of Large Urban School Districts during the COVID-19 Pandemic. J Urban Health 2020; 97:759-775. [PMID: 32959216 PMCID: PMC7505491 DOI: 10.1007/s11524-020-00476-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Reduced access to school meals during public health emergencies can accelerate food insecurity and nutritional status, particularly for low-income children in urban areas. To prevent the exacerbation of health disparities, there is a need to understand the implementation of meal distribution among large urban school districts during emergencies and to what degree these strategies provide equitable meal access. Our case study of four large urban school districts during the COVID-19 pandemic aims to address these knowledge gaps. Guided by the Getting to Equity (GTE) framework, we conducted a mixed-methods study evaluating emergency meal distribution and strategy implementation in four large urban school districts (Chicago Public Schools, Houston Independent School District, Los Angeles Unified School District, and New York City Department of Education). We gathered data from school district websites on (1) meal service and delivery sites and (2) district documents, policies, communication, and resources. Using qualitative coding approaches, we identified unique and shared district strategies to address meal distribution and communications during the pandemic according to the four components of the GTE framework: increase healthy options, reduce deterrents, build on community capacity, and increase social and economic resources. We matched district census tract boundaries to demographic data from the 2018 American Community Survey and United States Department of Agriculture food desert data, and used geographic information systems (GIS) software to identify meal site locations relative to student population, areas of high poverty and high minority populations, and food deserts. We found that all districts developed strategies to optimize meal provision, which varied across case site. Strategies to increase healthy options included serving adults and other members of the general public, providing timely information on meal site locations, and promoting consumption of a balanced diet. The quantity and frequency of meals served varied, and the degree to which districts promoted high-quality nutrition was limited. Reducing deterrents related to using inclusive language and images and providing safety information on social distancing practices in multiple languages. Districts built community capacity through partnering with first responder, relief, and other community organizations. Increased social and economic resources were illustrated by providing technology assistance to families, childcare referrals for essential workers, and other wellness resources. Geospatial analysis suggests that service locations across cities varied to some degree by demographics and food environment, with potential gaps in reach. This study identifies strategies that have the potential to increase equitable access to nutrition assistance programs. Our findings can support (1) ongoing efforts to address child food insecurity during the pandemic and (2) future meal provision through programs like the Summer Food Service Program and Seamless Summer Option. Future research should further examine the rationale behind meal site placement and how site availability changed over time.
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Phillips AZ, Rodriguez HP. U.S. county "food swamp" severity and hospitalization rates among adults with diabetes: A nonlinear relationship. Soc Sci Med 2020; 249:112858. [PMID: 32088514 PMCID: PMC7430494 DOI: 10.1016/j.socscimed.2020.112858] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 12/09/2019] [Accepted: 02/13/2020] [Indexed: 12/11/2022]
Abstract
The relationship between food environments and diabetes morbidity is vastly understudied, despite the well-recognized linkage between dietary quality and diabetes complications. Further, literature demonstrates that attributes of places can have nonlinear relationships with health outcomes. This study examines the extent to which "food swamps" are associated with greater rates of hospitalizations for complications among adults with diabetes over time as well as the linearity of this relationship. We conduct a longitudinal county-level analysis of 832 counties across 16 U.S. states in 2010, 2012, and 2014 using data from the USDA Food Environment Atlas and the AHRQ Health Care Cost and Utilization Project State Inpatient Databases. Food swamp severity is measured as the percentage of food outlets in a county that sell primarily unhealthy foods. Hierarchical linear mixed models with county random intercepts are estimated, controlling for area-level covariates and state and year fixed effects. Curvilinear relationships are explored by additively incorporating quadratic terms. We find that, over the study period, mean food swamp severity remained relatively stable. Mean hospitalization rates decreased from 296.72 to 262.82 hospitalizations per 1000 diabetic adults (p < 0.001). In adjusted models, greater food swamp severity was associated with higher hospitalization rates in a curvilinear manner (severity: β = 2.181, p = 0.02; severity2: β = -0.017, p = 0.04), plateauing at approximately 64% unhealthy outlets, a saturation point observed in 17% of observations. Policies that limit saturation of the environment with unhealthy outlets may help in the prevention of diabetic complications, but more saturated counties will likely require more extensive intervention.
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Affiliation(s)
- Aryn Z Phillips
- University of California, Berkeley, School of Public Health, Center for Healthcare Organizational and Innovation Research, 2121 Berkeley Way West, Berkeley, CA, 94720-1650, USA.
| | - Hector P Rodriguez
- University of California, Berkeley, School of Public Health, Center for Healthcare Organizational and Innovation Research, 2121 Berkeley Way West, Berkeley, CA, 94720-1650, USA.
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Stacy CP, Schilling J, Gourevitch R, Lowy J, Meixell B, Thornton RLJ. Bridging the Housing and Health Policy Divide: Lessons in Community Development from Memphis and Baltimore. HOUSING POLICY DEBATE 2019; 29:403-420. [PMID: 31564815 PMCID: PMC6764778 DOI: 10.1080/10511482.2018.1539858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 10/20/2018] [Indexed: 06/10/2023]
Abstract
Governments and nonprofits routinely partner to launch place-based initiatives in distressed neighborhoods with the goal of stabilizing real estate markets, reclaiming vacant properties, abating public nuisances, and reducing crime. Public health impacts and outcomes are rarely the major policy drivers in the design and implementation of these neighborhood scale initiatives. In this article, we examine recent Health Impact Assessments in Baltimore, Maryland and Memphis, Tennessee to show how public health concepts, principles, and practices can be infused into existing and new programs and policies, and how public health programs can help to improve population health by addressing the upstream social determinants of health. We provide a portfolio of ideas and practices to bridge this classic divide of housing and health policy.
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Affiliation(s)
- Christina Plerhoples Stacy
- Corresponding author. The Urban Institute, 2100 M Street NW, Washington, DC 20037, U.S.; ; (607)329-1096
| | - Joseph Schilling
- The Urban Institute, 2100 M Street NW, Washington, DC 20037, US; ; 202-261-5982
| | - Ruth Gourevitch
- The Urban Institute, 2100 M Street NW, Washington, DC 20037, U.S.; ;(202)261-5873
| | - Jacob Lowy
- Department of Pediatrics, The Johns Hopkins School of Medicine, 5200 Eastern Avenue, Suite 4200, Baltimore, MD, 21224, U.S.; ; (410)550-4115
| | - Brady Meixell
- The Urban Institute, 2100 M Street NW, Washington, DC 20037, U.S.; ; (202)261-5236
| | - Rachel L J Thornton
- Department of Pediatrics, Johns Hopkins School of Medicine, and Johns Hopkins School of Public Health, Department of Health, Behavior, and Society, 5200 Eastern Avenue, Suite 4200, Baltimore, MD, 21224, U.S.; ; (410)550-4226
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Mui Y, Jones-Smith JC, Thornton RLJ, Pollack Porter K, Gittelsohn J. Relationships between Vacant Homes and Food Swamps: A Longitudinal Study of an Urban Food Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111426. [PMID: 29160811 PMCID: PMC5708065 DOI: 10.3390/ijerph14111426] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 12/04/2022]
Abstract
Research indicates that living in neighborhoods with high concentrations of boarded-up vacant homes is associated with premature mortality due to cancer and diabetes, but the mechanism for this relationship is unclear. Boarded-up housing may indirectly impact residents’ health by affecting their food environment. We evaluated the association between changes in vacancy rates and changes in the density of unhealthy food outlets as a proportion of all food outlets, termed the food swamp index, in Baltimore, MD (USA) from 2001 to 2012, using neighborhood fixed-effects linear regression models. Over the study period, the average food swamp index increased from 93.5 to 95.3 percentage points across all neighborhoods. Among non-African American neighborhoods, increases in the vacancy rate were associated with statistically significant decreases in the food swamp index (b = −0.38; 90% CI, −0.64 to −0.12; p-value: 0.015), after accounting for changes in neighborhood SES, racial diversity, and population size. A positive association was found among low-SES neighborhoods (b = 0.15; 90% CI, 0.037 to 0.27; p-value: 0.031). Vacant homes may influence the composition of food outlets in urban neighborhoods. Future research should further elucidate the mechanisms by which more distal, contextual factors, such as boarded-up vacant homes, may affect food choices and diet-related health outcomes.
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Affiliation(s)
- Yeeli Mui
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Jessica C Jones-Smith
- Department of Health Services & Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Rachel L J Thornton
- Center for Child and Community Health Research, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Institute for Health and Social Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
- Global Obesity Prevention Center (GOPC) at Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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