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Edwards JR, Ong C, Barber S, Headen I, Tabb LP, De Roos AJ, Schinasi LH. Methodologic Strategies for Quantifying Associations of Historical and Contemporary Mortgage Discrimination on Population Health Equity: A Systematic Review. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02137-3. [PMID: 39289334 DOI: 10.1007/s40615-024-02137-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 09/19/2024]
Abstract
BACKGROUND Mortgage discrimination refers to the systematic withholding of home mortgages from minoritized groups. In recent years, there has been an increase in empirical research investigating associations of historical and contemporary mortgage discrimination on contemporary outcomes. Investigators have used a variety of measurement methods and approaches, which may have implications for results and interpretation. PURPOSE We conducted a systematic review of peer-reviewed literature that has quantified links between both historical and current mortgage discrimination with contemporary adverse environmental, social, and health outcomes. Our goals were to document the methodology used to measure and assign mortgage discrimination, to assess implications for results and interpretation, and to make recommendations for future work. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines, literature searches were conducted in September 2022 using terms that combined concepts of mortgage discrimination, health, and neighborhood environment. RESULTS In total, 45 papers fit the eligibility criteria. In these, researchers investigated associations between mortgage discrimination and: (1) health outcomes (N = 28); (2) environmental and social exposures including heat, air pollution, greenspace, soil lead levels, and crime (N = 12); and (3) built environment features, including presence of retail alcohol, fast food, and tobacco stores (N = 5). Eleven included studies used Home Mortgage Discrimination Act (HMDA) data to identify racialized bias in mortgage discrimination or redlining, and 34 used Homeowner Loan Corporation (HOLC) maps. The construction and parametrization of mortgage discrimination or redlining and the spatial assignment of HOLC grades to contemporary addresses or neighborhoods varied substantially across studies. CONCLUSIONS Results from our review suggest the need for careful consideration of optimal methods to analyze mortgage discrimination such as HOLC spatial assignment or HMDA index parametrization, contemplation of covariates, and place-based knowledge of the study location.
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Affiliation(s)
- Janelle R Edwards
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA.
- Dornsife School of Public Health, Ubuntu Center On Racism, Global Movements, and Population Health Equity, Drexel University, Philadelphia, PA, USA.
| | - Christian Ong
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Sharrelle Barber
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Ubuntu Center On Racism, Global Movements, and Population Health Equity, Drexel University, Philadelphia, PA, USA
| | - Irene Headen
- Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Ubuntu Center On Racism, Global Movements, and Population Health Equity, Drexel University, Philadelphia, PA, USA
| | - Loni P Tabb
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Ubuntu Center On Racism, Global Movements, and Population Health Equity, Drexel University, Philadelphia, PA, USA
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
| | - Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Urban Health Collaborative, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Ubuntu Center On Racism, Global Movements, and Population Health Equity, Drexel University, Philadelphia, PA, USA
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Michel KH, Treffers RD, O'Malley E, Adler SS. Overview of State Laws Restricting Alcohol Outlet Density in the United States. JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE 2024; 30:558-566. [PMID: 38870373 DOI: 10.1097/phh.0000000000001944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2024]
Abstract
OBJECTIVES Complementing the extensive research literature demonstrating that increased alcohol outlet density is associated with excessive alcohol consumption and related harms, this article synthesizes information on the types of alcohol outlet density restrictions in US state-level laws. DESIGN Statutes and regulations related to alcohol outlet density in all 50 states and the District of Columbia in effect as of January 1, 2022, were collected using Westlaw. State-level density restrictions were coded according to 4 variables and overlaid with existing research on state-specific local authority to regulate outlet density. Alcohol outlet density laws in Michigan and Massachusetts were analyzed in detail as case studies. SETTING United States. MAIN OUTCOME MEASURE US state-level licensing laws restricting alcohol outlet density. RESULTS Thirty-three states and the District of Columbia have state-level licensing laws that limit alcohol outlet density. Of those, 25 have population-based restrictions, 8 have distance-based restrictions, 7 have quotas, and 6 require the licensing agency to consider density-related factors. Within the same group of 34 jurisdictions, 22 apply restrictions to both on- and off-premises outlets, 5 apply them only to on-premises outlets, and 7 apply them only to off-premises outlets. Among the 32 states where localities lack authority to license alcohol outlets, two-thirds have state-level laws restricting outlet density. State-level density restrictions also exist in approximately two-thirds of the states where localities have licensing authority. Case studies of Michigan and Massachusetts highlight how state-level density restrictions operate in practice. CONCLUSIONS Two-thirds of jurisdictions have state-level alcohol outlet density restrictions, with population-based restrictions being the most common. In addition, outlet density restrictions may exist regardless of limits on local control and whether localities with authority to enact density restrictions have done so. Policymakers and others can reference this assessment to identify examples and opportunities to strengthen the alcohol policy environment in any given state.
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Affiliation(s)
- Katie H Michel
- Author Affiliations: ChangeLab Solutions, Oakland (Drs Michel, O'Malley, and Adler); and Legal & Policy Research Consultant, Morgan Hill, California (Dr Treffers)
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So M, El Baassiri MG, Price MD, Byrne JP, Haut ER, Nasr IW. Examining the Influence of Historical Redlining on Firearm Injuries in Current Day Baltimore, Maryland. RESEARCH SQUARE 2024:rs.3.rs-4534823. [PMID: 38978569 PMCID: PMC11230467 DOI: 10.21203/rs.3.rs-4534823/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
Firearm injuries are a common and major public health problem in Baltimore, Maryland. The city is also one of the first U.S. cities in which the 1930s discriminatory practice of redlining first emerged. This study examines the association between current day firearm injuries and residence in these historically redlined areas at a neighborhood level using zip codes. Firearm injury outcomes in patients who presented to a hospital in Maryland from 2015 to 2020 were measured from the Health Services Cost Review Commission (HSCRC) in conjunction with both geospatial data from Richmond's Digital Scholarship Lab's Mapping Inequality project and population data from the U.S. Census. A redlining score was calculated to represent the extent of redlining in each zip code. Negative binomial regression models were utilized to measure the association between neighborhood zip codes and rate of firearm injuries. Our adjusted regression model shows that for every one-unit increase of the Home Owners' Loan Corporation (HOLC) redlining score, there is a 2.24-fold increase in the rate of firearm injuries (RR 2.24; 95% CI: 0.31, 1.31, p < 0.001). These findings suggest a strongassociation between historically redlined areas and population risk of firearm injury today. Further research is needed to investigate the underlying mechanisms that may contribute to this relationship, such as access to firearms or social and economic factors. Overall, our study highlights the potential impact of historical redlining policies on contemporary health outcomes in Baltimore.
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Affiliation(s)
- Marianne So
- Johns Hopkins Children's Center Division of General Pediatric Surgery
| | | | - Matthew D Price
- Johns Hopkins Department of Surgery: Johns Hopkins Medicine Department of Surgery
| | - James P Byrne
- Johns Hopkins Department of Surgery: Johns Hopkins Medicine Department of Surgery
| | - Elliott R Haut
- Johns Hopkins Department of Surgery: Johns Hopkins Medicine Department of Surgery
| | - Isam W Nasr
- Johns Hopkins Children's Center Division of General Pediatric Surgery
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Tam CC, Li L, Kosai S, Duhart Clarke SE, Ehlers CL, Karriker-Jaffe KJ. Protective effects of ethnic enclaves: Testing pathways to alcohol use and use disorders in Mexican American young adults. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024. [PMID: 38880996 DOI: 10.1002/ajcp.12756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/22/2024] [Accepted: 04/24/2024] [Indexed: 06/18/2024]
Abstract
Ethnic enclave residence is associated with decreased risk for drinking and related problems, but less is known about the mechanisms that explain this association. Informed by theories of social control, we used a multilevel framework to examine whether negative attitudes toward drinking mediated associations between ethnic enclave residence (i.e., neighborhood linguistic isolation) and alcohol outcomes among Mexican American young adults (N = 628) in Southern California. Model 1 assessed mediation effects in the pathways from linguistic isolation to current drinking and alcohol use disorder (AUD). Model 2 adjusted for parental drinking attitudes and neighborhood alcohol availability. There were differential associations by gender in direct effects of linguistic isolation and negative drinking attitudes on both drinking and AUD. Among women only, linguistic isolation was related to greater abstinence and decreased AUD after accounting for social control proxies of parent attitudes and alcohol availability. Young adults' own drinking attitudes did not mediate relationships between linguistic isolation and alcohol outcomes. This study offers evidence on the importance of disaggregating Hispanic national groups by gender to uncover social mechanisms within ethnic enclave settings for tailored supports in reducing risk of drinking and alcohol-related harms.
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Affiliation(s)
- Christina C Tam
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Libo Li
- Alcohol Research Group, Public Health Institute, Emeryville, California, USA
| | - Sam Kosai
- Health Practice Area, RTI International, Berkeley, California, USA
| | | | - Cindy L Ehlers
- Department of Neuroscience, Scripps Research Institute, San Diego, California, USA
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Hussaini SMQ, Fan Q, Barrow LCJ, Yabroff KR, Pollack CE, Nogueira LM. Association of Historical Housing Discrimination and Colon Cancer Treatment and Outcomes in the United States. JCO Oncol Pract 2024; 20:678-687. [PMID: 38320228 DOI: 10.1200/op.23.00426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/07/2023] [Indexed: 02/08/2024] Open
Abstract
PURPOSE In the 1930s, the federally sponsored Home Owners' Loan Corporation (HOLC) used racial composition in its assessment of areas worthy of receiving loans. Neighborhoods with large proportions of Black residents were mapped in red (ie, redlining) and flagged as hazardous for mortgage financing. Redlining created a platform for systemic disinvestment in these neighborhoods, leading to barriers in access to resources that persist today. We investigated the association between residing in areas with different HOLC ratings and receipt of quality cancer care and outcomes among individuals diagnosed with colon cancer-a leading cause of cancer deaths amenable to early detection and treatment. METHODS Individuals who resided in zip code tabulation areas in 196 cities with HOLC rating and were diagnosed with colon cancer from 2007 to 2017 were identified from the National Cancer Database and assigned a HOLC grade (A, best; B, still desirable; C, definitely declining; and D, hazardous and mapped in red). Multivariable logistic regression models investigated association of area-level HOLC grade and late stage at diagnosis and receipt of guideline-concordant care. The product-limit method evaluated differences in time to adjuvant chemotherapy. Multivariable Cox proportional hazard models investigated differences in overall survival (OS). RESULTS There were 149,917 patients newly diagnosed with colon cancer with a median age of 68 years. Compared with people living in HOLC A areas, people living in HOLC D areas were more likely to be diagnosed with late-stage disease (adjusted odds ratio, 1.06 [95% CI, 1.00 to 1.12]). In addition, people living in HOLC B, C, and D areas had 8%, 16%, and 24% higher odds of not receiving guideline-concordant care, including lower receipt of surgery, evaluation of ≥12 lymph nodes, and chemotherapy. People residing in HOLC B, C, or D areas also experienced delays in initiation of adjuvant chemotherapy after surgery. People residing in HOLC C (adjusted hazard ratio [aHR], 1.09 [95% CI, 1.05 to 1.13]) and D (aHR, 1.13 [95% CI, 1.09 to 1.18]) areas had worse OS, including 13% and 20% excess risk of death for individuals diagnosed with early- and 6% and 8% for late-stage disease for HOLC C and D, respectively. CONCLUSION Historical housing discrimination is associated with worse contemporary access to colon cancer care and outcomes.
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Affiliation(s)
- S M Qasim Hussaini
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Hospital, Baltimore, MD
| | - Qinjin Fan
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA
| | - Lauren C J Barrow
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Nursing, Baltimore, MD
| | - K Robin Yabroff
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA
| | - Craig E Pollack
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health and Johns Hopkins School of Nursing, Baltimore, MD
| | - Leticia M Nogueira
- Department of Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA
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Nogueira L, Florez N. The Impact of Climate Change on Global Oncology. Hematol Oncol Clin North Am 2024; 38:105-121. [PMID: 37580192 DOI: 10.1016/j.hoc.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2023]
Abstract
Climate change is the greatest threat to human health of our time, with significant implications for global cancer control efforts. The changing frequency and behavior of climate-driven extreme weather events results in more frequent and increasingly unanticipated disruptions in access to cancer care. Given the significant threat that climate change poses to cancer control efforts, oncology professionals should champion initiatives that help protect the health and safety of patients with cancer, such as enhancing emergency preparedness and response efforts and reducing emissions from our own professional activities, which has health cobenefits for the entire population.
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Affiliation(s)
- Leticia Nogueira
- Surveillance and Health Equity Sciences, American Cancer Society, Palm Harbor, FL, USA.
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Nogueira LM, Yabroff KR. Climate change and cancer: the Environmental Justice perspective. J Natl Cancer Inst 2024; 116:15-25. [PMID: 37813679 DOI: 10.1093/jnci/djad185] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 08/29/2023] [Accepted: 08/31/2023] [Indexed: 10/11/2023] Open
Abstract
Despite advances in cancer control-prevention, screening, diagnosis, treatment, and survivorship-racial disparities in cancer incidence and survival persist and, in some cases, are widening in the United States. Since 2020, there's been growing recognition of the role of structural racism, including structurally racist policies and practices, as the main factor contributing to historical and contemporary disparities. Structurally racist policies and practices have been present since the genesis of the United States and are also at the root of environmental injustices, which result in disproportionately high exposure to environmental hazards among communities targeted for marginalization, increased cancer risk, disruptions in access to care, and worsening health outcomes. In addition to widening cancer disparities, environmental injustices enable the development of polluting infrastructure, which contribute to detrimental health outcomes in the entire population, and to climate change, the most pressing public health challenge of our time. In this commentary, we describe the connections between climate change and cancer through an Environmental Justice perspective (defined as the fair treatment and meaningful involvement of people of all racialized groups, nationalities, or income, in all aspects, including development, implementation, and enforcement, of policies and practices that affect the environment and public health), highlighting how the expertise developed in communities targeted for marginalization is crucial for addressing health disparities, tackling climate change, and advancing cancer control efforts for the entire population.
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Affiliation(s)
- Leticia M Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
| | - K Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, GA, USA
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Kong AY, Herbert L, Feldman JM, Trangenstein PJ, Fakunle DO, Lee JGL. Tobacco and Alcohol Retailer Availability and Neighborhood Racialized, Economic, and Racialized Economic Segregation in North Carolina. J Racial Ethn Health Disparities 2023; 10:2861-2871. [PMID: 36469288 DOI: 10.1007/s40615-022-01463-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 11/14/2022] [Accepted: 11/15/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Despite evidence of racialized and socioeconomic inequities in tobacco and alcohol outlet availability, few studies have investigated spatial inequities in areas experiencing both concentrated residential racialized segregation and socioeconomic disadvantage. This study examined whether segregation-racialized, economic or both-was associated with alcohol and tobacco retailer counts in North Carolina (NC). METHODS The NC Alcoholic Beverage Control Commission provided lists of 2021 off-premise alcohol retailers. We created a list of 2018 probable tobacco retailers using ReferenceUSA. We calculated three census tract-level measures of the Index of Concentrations at the Extremes (ICE), indicating racialized segregation between non-Hispanic White and Black residents and economic segregation based on household income. We used negative binomial regression to test associations between quintiles of each ICE measure and tobacco and, separately, alcohol retailer counts. RESULTS Tracts with the greatest racialized disadvantage had 38% (IRR, 1.38; 95% CI, 1.15-1.66) and 65% (IRR, 1.65; 95% CI, 1.34-2.04) more tobacco and alcohol outlets, respectively, as tracts with the lowest. Tracts with the highest racialized economic disadvantage had a predicted count of 1.51 tobacco outlets per 1000 people while those in the lowest had nearly one fewer predicted outlet. Similar inequities existed in the predicted count of alcohol outlets. DISCUSSION Tobacco and alcohol outlet availability are higher in NC places experiencing concentrated racialized and economic segregation. A centralized agency overseeing tobacco and alcohol outlet permits and strategies to reduce the retail availability of these harmful products (e.g., capping the number of permits) are needed to intervene upon these inequities.
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Affiliation(s)
- Amanda Y Kong
- Department of Family and Preventive Medicine, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
- TSET Health Promotion Research Center, Stephenson Cancer Center, The University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
| | - Lily Herbert
- Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - David O Fakunle
- Public Health Program, Morgan State University School of Community Health & Policy, Baltimore, MD, USA
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Bostean G, Ponicki WR, Padon AA, McCarthy WJ, Unger JB. A statewide study of disparities in local policies and tobacco, vape, and cannabis retail environments. Prev Med Rep 2023; 35:102373. [PMID: 37691887 PMCID: PMC10483047 DOI: 10.1016/j.pmedr.2023.102373] [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: 03/27/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 09/12/2023] Open
Abstract
The current study: (1) assesses sociodemographic disparities in local policies related to tobacco and cannabis retail, and (2) examines the cross-sectional association between policy strength and retailer densities of tobacco, e-cigarette (vape), and cannabis retailers within California cities and county unincorporated areas (N = 539). We combined (a) American Community Survey data (2019 5-year estimates), (b) 2018 tobacco, vape, and cannabis retailer locations from a commercial data provider, (c) 2017 tobacco and vape retail environment policy data from American Lung Association, and (d) 2018 cannabis policy data from California Cannabis Local Laws Database. Conditional autoregressive models examined policy strength associations with sociodemographic composition and retailer density in California jurisdictions. Jurisdictions with larger percentages of Black and foreign-born residents had stronger tobacco and vape policies. For cannabis policy, only income had a small, significant positive association with policy strength. Contrary to hypothesis, tobacco/vape policies were not significantly associated with retailer density, but cannabis policy strength was associated with lower cannabis retailer density (relative rate = 0.58, 95% Uncertainty Interval 0.47-0.70)-this effect was completely driven by storefront bans. Thus, storefront cannabis bans were the only policy studied that was associated with lower cannabis retailer density. Further research is needed to understand policies and disparities in retail environments for tobacco, vape, and cannabis, including data on the prospective association between policy implementation and subsequent retailer density, and the role of enforcement.
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Affiliation(s)
- Georgiana Bostean
- Sociology Department, Environmental Science & Policy Program, Chapman University, One University Drive, Orange, CA 92866, USA
| | - William R. Ponicki
- Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA
| | | | - William J. McCarthy
- Department of Health Policy & Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jennifer B. Unger
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
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Jay J, Allen K. Curbing the Epidemic of Community Firearm Violence after the Bruen Decision. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2023; 51:77-82. [PMID: 37226753 PMCID: PMC10209991 DOI: 10.1017/jme.2023.42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The Supreme Court's decision in New York State Rifle & Pistol Association Inc. v. Bruen undermines the ability of cities and states to regulate firearms safety. Nonetheless, we remain hopeful that firearm violence can decline even after the Bruen decision. Several promising public health approaches have gained broader adoption in recent years. This essay examines the key drivers of community firearm violence and reviews promising strategies to reverse those conditions, including community violence intervention (CVI) programs and place-based and structural interventions.
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Affiliation(s)
- Jonathan Jay
- BOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH, BOSTON, MASSACHUSETTS, USA
| | - Kalice Allen
- BOSTON UNIVERSITY SCHOOL OF PUBLIC HEALTH, BOSTON, MASSACHUSETTS, USA
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Hassan AM, Nogueira L, Lin YL, Rogers JE, Nori-Sarma A, Offodile AC. Impact of Heatwaves on Cancer Care Delivery: Potential Mechanisms, Health Equity Concerns, and Adaptation Strategies. J Clin Oncol 2023:JCO2201951. [PMID: 37098249 DOI: 10.1200/jco.22.01951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Affiliation(s)
- Abbas M Hassan
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Yu-Li Lin
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Jane E Rogers
- Pharmacy Clinical Programs, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Amruta Nori-Sarma
- Department of Environmental Health, Boston University School of Public Health, Boston, MA
| | - Anaeze Chidiebele Offodile
- Department of Plastic & Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, TX
- Institute for Cancer Care Innovation, The University of Texas MD Anderson Cancer Center, Houston, TX
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Friesen EL, Staykov E, Myran DT. Understanding the association between neighbourhood socioeconomic status and grocery store alcohol sales following market liberalization in Ontario, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:254-263. [PMID: 36214995 PMCID: PMC10036712 DOI: 10.17269/s41997-022-00694-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 08/31/2022] [Indexed: 03/24/2023]
Abstract
OBJECTIVES In 2015, Ontario partially deregulated alcohol sales by allowing grocery stores to sell alcohol. The purpose of this study was to evaluate (1) whether neighbourhood-level socioeconomic status (SES) impacted the likelihood that a grocery store began selling alcohol, and (2) whether increases in alcohol retail availability following deregulation differed between neighbourhoods based on SES. METHODS This was a repeated cross-sectional analysis of 1062 grocery stores in 17,096 neighbourhoods in urban Ontario. The association between neighbourhood-level SES and whether a grocery store began selling alcohol was modeled using mixed effect logistic regression. The annual change in drive-distance from a neighbourhood to the closest off-premise alcohol outlet between 2015 and 2020 was modeled using mixed effect linear regression. An interaction between time and SES was included to evaluate whether this change differed between neighbourhoods based on SES. RESULTS Grocery stores in neighbourhoods in the lowest SES quintile were 39% less likely to start selling alcohol than grocery stores in neighbourhoods in the highest SES quintile (odds ratio (OR): 0.61, 95% confidence interval (CI): 0.39-0.94). As grocery store sales expanded, the distance to the closest off-premise alcohol outlet decreased by 51.8 m annually (95% CI: 48.8-54.9, p < 0.01). A significant interaction between year and SES was observed whereby this trend was more pronounced in high- versus low-SES neighbourhoods. CONCLUSION The expansion of grocery store alcohol sales increased alcohol availability, but this increase was proportionately larger in high- versus low-SES neighbourhoods. This reduced historic disparities in alcohol availability between low- and high-SES neighbourhoods.
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Affiliation(s)
- Erik Loewen Friesen
- Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario, Canada.
| | - Emiliyan Staykov
- Michael G. DeGroote School of Medicine, Hamilton, Ontario, Canada
- University of Ottawa, Ottawa, Ontario, Canada
| | - Daniel Thomas Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Myran DT, Friesen EL, Dickson S, Konikoff L, Arora G, Tanuseputro P. Access to legal cannabis market in Canada over the four years following non-medical cannabis legalisation. Drug Alcohol Rev 2023. [PMID: 36933893 DOI: 10.1111/dar.13650] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/01/2023] [Accepted: 03/01/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION An increasing number of countries are inthe process of legalising non-medical cannabis. We described how the legal market has changed over the first 4 years following legalisation in Canada. METHODS We collected longitudinal data on operating status and location of all legal cannabis stores in Canada for the first 4 years following legalisation. We examined per capita stores and sales, store closures, and the drive time between stores and each neighbourhood in Canada. We compared measures between public and private retail systems. RESULTS Four years after legalisation, there were 3305 cannabis stores open in Canada (10.6 stores per 100,000 individuals aged 15+ years). Canadians spent $11.85CAD a month on cannabis per individual aged 15+ years, and 59% of neighbourhoods were within a 5-minute drive of a cannabis store. Over 4 years, per capita stores and per capita sales increased each year by an average of 122.3% and 91.7%, respectively, with larger increases in private versus public systems (4.01 times greater for per capita stores and 2.46 times greater for per capita sales). The annual increase in per capita stores and sales during the first 3 years was 6.0 and 15.5 times greater, respectively, than the increase in the fourth year following legalisation. Over 4 years, 7% of retail store locations permanently closed. DISCUSSION AND CONCLUSION The legal cannabis market in Canada expanded enormously over the first 4 years following legalisation, with considerable variation in access between jurisdictions. The rapid retail expansion has implications for evaluation of health impacts of non-medical legalisation.
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Affiliation(s)
- Daniel Thomas Myran
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Family Medicine, University of Ottawa, Ottawa, Canada.,ICES, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Erik Loewen Friesen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada.,ICES Central, Toronto, Canada
| | - Sarah Dickson
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Institut du Savoir Montfort, Ottawa, Canada
| | - Lauren Konikoff
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Gaurav Arora
- Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tanuseputro
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,ICES, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Medicine, University of Ottawa, Ottawa, Canada.,Bruyere Research Institute, Ottawa, Canada
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14
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Haley SJ, Jardine SJ, Kelvin EA, Herrmann C, Maroko AR. Neighborhood Alcohol Outlet Density, Historical Redlining, and Violent Crime in NYC 2014-2018. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3212. [PMID: 36833907 PMCID: PMC9963869 DOI: 10.3390/ijerph20043212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 06/18/2023]
Abstract
Alcohol outlets tend to cluster in lower income neighborhoods and do so disproportionately in areas with more residents of color. This study explores the association between on- and off-premise alcohol outlet density and history of redlining with violent crime in New York City between 2014 and 2018. Alcohol outlet density was calculated using a spatial accessibility index. Multivariable linear regression models assess associations between the history of redlining, on-premise and off-premise alcohol outlet density with serious crime. Each unit increase in on- and off-premise alcohol density was associated with a significant increase in violent crime (β = 3.1, p < 0.001 on-premise and β = 33.5, p < 0.001 off premise). In stratified models (redlined vs not redlined community block groups) the association between off-premise alcohol outlet density and violent crime density was stronger in communities with a history of redlining compared to those without redlining (β = 42.4, p < 0.001 versus β = 30.9, p < 0.001, respectively). However, on-premise alcohol outlet density was only significantly associated with violent crime in communities without a history of redlining (β = 3.6, p < 0.001). The violent crime experienced by formerly redlined communities in New York City is likely related to a legacy of racialized housing policies and may be associated with state policies that allow for high neighborhood alcohol outlet density.
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Affiliation(s)
- Sean J. Haley
- Department of Health Policy and Management, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10027, USA
| | - Shari J. Jardine
- Department of Health Policy and Management, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10027, USA
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10027, USA
| | - Elizabeth A. Kelvin
- Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10019, USA
- CUNY Institute for Implementation Science in Population Health, City University of New York, New York, NY 10027, USA
- Department of Occupational Health, Epidemiology & Prevention, Donald and Barbara Zucker School of Medicine at Hofstra University/Northwell Health, Hempstead, NY 11549, USA
| | - Christopher Herrmann
- Department of Law & Police Science, John Jay College, City University of New York, New York, NY 10027, USA
| | - Andrew R. Maroko
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY 10027, USA
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15
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Tucker JA, Buscemi J, Murphy JG, Reed DD, Vuchinich RE. Addictive behavior as molar behavioral allocation: Distinguishing efficient and final causes in translational research and practice. PSYCHOLOGY OF ADDICTIVE BEHAVIORS 2023; 37:1-12. [PMID: 35787099 PMCID: PMC9811182 DOI: 10.1037/adb0000845] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Translational research on addictive behaviors viewed as molar behavioral allocation is critically reviewed. This work relates rates of behavior to rates of reinforcement over time and has been fruitfully applied to addictive behaviors, which involve excessive allocation to short-term rewards with longer term costs. METHOD Narrative critical review. RESULTS This approach distinguishes between final and efficient causes of discrete behaviors. The former refers to temporally extended behavior patterns into which the act fits. The latter refers to environmental stimuli or internal psychological mechanisms immediately preceding the act. Final causes are most clear when addictive behaviors are studied over time as a function of changing environmental circumstances. Discrete acts of addictive behavior are part of an extended/molar behavior pattern when immediate constraints on engagement are low and few rewarding alternatives are available. Research framed by efficient causes often use behavioral economic simulation tasks as individual difference variables that precede discrete acts. Such measures show higher demand for addictive commodities and steeper discounting in various risk groups, but whether they predict molar addictive behavior patterning is understudied. CONCLUSIONS Although efficient cause analysis has dominated translational research, research supports viewing addictive behavior as molar behavioral allocation. Increasing concern with rate variables underpinning final cause analysis and considering how study methods and temporal units of analysis inform an efficient or final cause analysis may advance understanding of addictive behaviors that occur over time in dynamic environmental contexts. This approach provides linkages between behavioral science and disciplines that study social determinants of health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jalie A. Tucker
- University of Florida and Center for Behavioral Economic Health
Research, Gainesville, FL
| | | | | | - Derek D. Reed
- University of Kansas and Cofrin Logan Center for Addiction Research
& Treatment, Lawrence, KS
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16
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Uzzi M, Aune KT, Marineau L, Jones FK, Dean LT, Jackson JW, Latkin CA. An intersectional analysis of historical and contemporary structural racism on non-fatal shootings in Baltimore, Maryland. Inj Prev 2023; 29:85-90. [PMID: 36301795 PMCID: PMC9877125 DOI: 10.1136/ip-2022-044700] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Accepted: 08/05/2022] [Indexed: 02/03/2023]
Abstract
Introduction Non-fatal shooting rates vary tremendously within cities in the USA. Factors related to structural racism (both historical and contemporary) could help explain differences in non-fatal shooting rates at the neighbourhood level. Most research assessing the relationship between structural racism and firearm violence only includes one dimension of structural racism. Our study uses an intersectional approach to examine how the interaction of two forms of structural racism is associated with spatial non-fatal shooting disparities in Baltimore, Maryland. Methods We present three additive interaction measures to describe the relationship between historical redlining and contemporary racialized economic segregation on neighbourhood-level non-fatal shootings. Results Our findings revealed that sustained disadvantage census tracts (tracts that experience contemporary socioeconomic disadvantage and were historically redlined) have the highest burden of non-fatal shootings. Sustained disadvantage tracts had on average 24 more non-fatal shootings a year per 10 000 residents compared with similarly populated sustained advantage tracts (tracts that experience contemporary socioeconomic advantage and were not historically redlined). Moreover, we found that between 2015 and 2019, the interaction between redlining and racialized economic segregation explained over one-third of non-fatal shootings (approximately 650 shootings) in sustained disadvantage tracts. Conclusion These findings suggest that the intersection of historical and contemporary structural racism is a fundamental cause of firearm violence inequities in Baltimore. Intersectionality can advance injury prevention research and practice by (1) serving as an analytical tool to expose inequities in injury-related outcomes and (2) informing the development and implementation of injury prevention interventions and policies that prioritise health equity and racial justice.
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Affiliation(s)
- Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Center for Gun Violence Solutions, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Kyle T Aune
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lea Marineau
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA
| | - Forrest K Jones
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Lorraine T Dean
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Hopkins Center for Health Disparities Solutions, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - John W Jackson
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Biostatistics, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Carl A Latkin
- Department of Health, Behavior and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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17
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Vuchinich RE, Tucker JA, Acuff SF, Reed DD, Buscemi J, Murphy JG. Matching, behavioral economics, and teleological behaviorism: Final cause analysis of substance use and health behavior. J Exp Anal Behav 2023; 119:240-258. [PMID: 36541360 DOI: 10.1002/jeab.815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022]
Abstract
Howard Rachlin and his contemporaries pioneered basic behavioral science innovations that have been usefully applied to advance understanding of human substance use disorder and related health behaviors. We briefly summarize the innovations of molar behaviorism (the matching law), behavioral economics, and teleological behaviorism. Behavioral economics and teleological behaviorism's focus on final causes are especially illuminating for these applied fields. Translational and applied research are summarized for laboratory studies of temporal discounting and economic demand, cohort studies of alcohol and other drug use in the natural environment, and experimental behavioral economic modeling of health behavior-related public health policies. We argue that the teleological behavioral perspective on health behavior is conducive to and merges seamlessly with the contemporary socioecological model of health behavior, which broadens the contextual influences (e.g., community, economic, infrastructure, health care access and policy) of individuals' substance use and other health risk behaviors. Basic-to-applied translations to date have been successful and bode well for continued applications of basic science areas pioneered by Howard Rachlin and his contemporaries.
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Affiliation(s)
| | - Jalie A Tucker
- University of Florida and Center for Behavioral Economic Health Research, Gainesville, FL
| | | | - Derek D Reed
- University of Kansas and Cofrin Logan Center for Addiction Research and Treatment, Lawrence, KS
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18
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Pichardo MS, Pichardo CM, Talavera GA, Gallo LC, Castañeda SF, Sotres-Alvarez D, Molina Y, Evenson KR, Daviglus ML, Hou L, Joyce B, Aviles-Santa L, Plascak J. Neighborhood segregation and cancer prevention guideline adherence in US Hispanic/Latino adults: Results from the HCHS/SOL. Front Oncol 2022; 12:1024572. [PMID: 36601483 PMCID: PMC9806719 DOI: 10.3389/fonc.2022.1024572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/26/2022] [Indexed: 12/23/2022] Open
Abstract
Background Adherence to the American Cancer Society (ACS) guidelines for cancer prevention is associated with a lower risk of cancer and mortality. The role of neighborhood segregation on adherence to the guidelines among Hispanic/Latino adults is relatively unexplored. Materials and methods The Hispanic Community Health Study/Study of Latinos is a community-based prospective cohort of 16,462 Hispanic/Latino adults, ages 18-74 years enrolled in 2008-2011 from the Bronx, Chicago, Miami and San Diego. Dimensions of neighborhood segregation were measured using 2010 United States' census tracts:-evenness (the physical separation of a group), exposure (the propensity for contact between groups), and their joint effect (hypersegregation). ACS guideline adherence levels - low, moderate, high - were created from accelerometry-measured physical activity, dietary intake, alcohol intake, and body mass index. Weighted multinominal logistic regressions estimated relative risk ratios (RRR) and 95% confidence intervals (CI) for guideline adherence levels and its components. Results Hispanic/Latino adults were classified as low (13.7%), moderate (58.8%) or highly (27.5%) adherent to ACS guidelines. We found no evidence of an association between segregation and overall guideline adherence. Exposure segregation associated with lower likelihood of moderate adherence to alcohol recommendations (RRRmoderate vs. low:0.86, 95%CI:0.75-0.98) but higher likelihood for diet recommendations (RRRmoderate vs. low:1.07, 95%CI:1.01-1.14). Evenness segregation associated with lower likelihood of high adherence to the physical activity recommendations (RRRhigh vs. low:0.73, 95%CI:0.57-0.94). Hypersegregation was associated with individual guideline components. Conclusion We found evidence of a cross-sectional relationship between neighborhood segregation and ACS cancer prevention guideline components, but not with overall ACS guideline adherence.
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Affiliation(s)
- Margaret S. Pichardo
- Department of Psychology, San Diego State University, San Diego, CA, United States,Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States,Department of Surgery, Hospital of the University of Pennsylvania, Penn Medicine, Philadelphia, PA, United States,*Correspondence: Margaret S. Pichardo,
| | - Catherine M. Pichardo
- Department of Psychology, San Diego State University, San Diego, CA, United States,Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States,Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, United States
| | - Gregory A. Talavera
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Sheila F. Castañeda
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Yamile Molina
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL, United States
| | - Kelly R. Evenson
- Department of Epidemiology, Northwestern University, Chicago, IL, United States
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Brian Joyce
- Department of Preventive Medicine, Northwestern University, Chicago, IL, United States
| | - Larissa Aviles-Santa
- National Institute on Minority Health and Health Disparities, Bethesda, MD, United States
| | - Jesse Plascak
- Division of Cancer Prevention and Control, Ohio State University, Columbus, OH, United States
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19
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Sadler RC, Wojciechowski TW, Trangenstein P, Harris A, Buchalski Z, Furr-Holden D. Linking Historical Discriminatory Housing Patterns to the Contemporary Alcohol Environment. APPLIED SPATIAL ANALYSIS AND POLICY 2022; 16:561-581. [PMID: 36532713 PMCID: PMC9734485 DOI: 10.1007/s12061-022-09493-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 11/16/2022] [Indexed: 05/21/2023]
Abstract
Research on alcohol outlet density consistently shows greater disparities in exposure in disinvested communities. Likewise, structural racism via discriminatory housing practices has created many of the issues that beset contemporary disinvested neighborhoods. Little work, however, has examined the relationship between housing practices and alcohol outlet disparities. The central premise of our work is that these discriminatory and inequitable practices create distinctions in the alcohol environment, and that such disparities have implications for work on alcohol policy. Here we link alcohol outlet density with a spatial database examining redlining, blockbusting, and gentrification in Baltimore, Maryland, and Flint, Michigan (two cities with common experiences of urban disinvestment over the last 50 years). Standard measures are used to account for the impacts of neighborhood racial, socioeconomic, and housing composition in a multilevel model. Our findings highlight that gentrification and redlining are strongly associated with alcohol outlet density, while blockbusting is not. Gentrification and redlining also frequently co-occur in inner-urban areas, while the more suburban phenomenon of blockbusting rarely overlaps with either. These findings further contextualize nascent work on structural racism in housing that illustrates important disparities along the lines of these distinct practices. Future work should consider how legacy impacts of discriminatory housing patterns impact our communities today.
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Affiliation(s)
| | | | | | - Alan Harris
- Michigan State University, 200 E 1st St., Flint, MI 48502 USA
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20
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The Relationship of Historical Redlining with Present-Day Neighborhood Environmental and Health Outcomes: A Scoping Review and Conceptual Model. J Urban Health 2022; 99:959-983. [PMID: 35915192 PMCID: PMC9342590 DOI: 10.1007/s11524-022-00665-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/31/2022] [Indexed: 12/31/2022]
Abstract
Following the Great Depression and related home foreclosures, the federal government established new agencies to facilitate access to affordable home mortgages, including the Home Owners' Loan Corporation (HOLC) and Federal Housing Administration (FHA). HOLC and FHA directed widespread neighborhood appraisals to determine investment risk, referred to as "redlining," which took into account residents' race. Redlining thereby contributed to segregation, disinvestment, and racial inequities in opportunities for homeownership and wealth accumulation. Recent research examines associations between historical redlining and subsequent environmental determinants of health and health-related outcomes. In this scoping review, we assess the extent of the current body of evidence, the range of outcomes studied, and key study characteristics, examining the direction and strength of the relationship between redlining, neighborhood environments, and health as well as different methodological approaches. Overall, studies nearly universally report evidence of an association between redlining and health-relevant outcomes, although heterogeneity in study design precludes direct comparison of results. We critically consider evidence regarding HOLC's causality and offer a conceptual framework for the relationship between redlining and present-day health. Finally, we point to key directions for future research to improve and broaden understanding of redlining's enduring impact and translate findings into public health and planning practice.
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21
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Mehranbod CA, Gobaud AN, Jacoby SF, Uzzi M, Bushover BR, Morrison CN. Historical redlining and the epidemiology of present-day firearm violence in the United States: A multi-city analysis. Prev Med 2022; 165:107207. [PMID: 36027991 PMCID: PMC10155117 DOI: 10.1016/j.ypmed.2022.107207] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 07/14/2022] [Accepted: 08/14/2022] [Indexed: 11/16/2022]
Abstract
Firearm violence is a major cause of morbidity, mortality, and racial health disparities in the United States. Previous studies have identified associations between historically racist housing discrimination (i.e., redlining practices) and firearm violence; however, these studies generally have been limited to a single city and have yet to provide sufficient evidence through which to determine the extent and dynamics of the impact of this relationship across the country. The aim of our study was (1) to estimate the association of historical redlining on both violent and firearm death across the country in nested models; and (2) to examine spatial non-stationarity to determine whether the impact of historical redlining on violent and firearm death was the same across the U.S. We used multilevel Bayesian conditional autoregressive Poisson models to determine the relationship between redlining as illustrated through Home Owners' Loan Corporation maps and 2019 violent and firearm deaths at the ZIP code-level nested within 21 cities across the U.S. We found that at the ZIP code level, there was a dose-responsive relationship between HOLC grading and the incidence of present-day firearm deaths. In general, redlined ZIP codes had higher relative incidence of firearm deaths. Associations were not stable across cities. For example, associations were relatively stronger in Baltimore, MD and weaker in Los Angeles, CA. This research reinforces the findings of previous studies examining the impact of redlining on firearm death across the extent of the entire country in 21 cities and claim that HOLC grades are associated with present-day violence.
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Affiliation(s)
- Christina A Mehranbod
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America.
| | - Ariana N Gobaud
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Sara F Jacoby
- School of Nursing, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Mudia Uzzi
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Center for Gun Violence Solutions, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America
| | - Brady R Bushover
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Christopher N Morrison
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States of America; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Australia
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22
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Edmonds AT, Rhew IC, Jones-Smith J, Chan KCG, De Castro AB, Rubinsky AD, Blosnich JR, Williams EC. Neighborhood Disadvantage, Patterns of Unhealthy Alcohol Use, and Differential Associations by Gender, Race/Ethnicity, and Rurality: A Study of Veterans Health Administration Patients. J Stud Alcohol Drugs 2022; 83:867-878. [PMID: 36484584 PMCID: PMC9756400 DOI: 10.15288/jsad.21-00110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 03/31/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Stressful conditions within disadvantaged neighborhoods may shape unhealthy alcohol use and related harms. Yet, associations between neighborhood disadvantage and more severe unhealthy alcohol use are underexplored, particularly for subpopulations. Among national Veterans Health Administration (VA) patients (2013-2017), we assessed associations between neighborhood disadvantage and multiple alcohol-related outcomes and examined moderation by sociodemographic factors. METHOD Electronic health record data were extracted for VA patients with a routine Alcohol Use Disorders Identification Test-Consumption (AUDIT-C) screen. Patient addresses were linked by census block group to the Area Deprivation Index (ADI), dichotomized at the 85th percentile, and examined in quintiles for sensitivity analyses. Using modified Poisson generalized estimating equations models, we estimated associations between neighborhood disadvantage and five outcomes: unhealthy alcohol use (AUDIT-C ≥ 5), any past-year heavy episodic drinking (HED), severe unhealthy alcohol use (AUDIT-C ≥ 8), alcohol use disorder (AUD) diagnosis, and alcohol-specific conditions diagnoses. Moderation by gender, race/ethnicity, and rurality was tested using multiplicative interaction. RESULTS Among 6,381,033 patients, residence in a highly disadvantaged neighborhood (ADI ≥ 85th percentile) was associated with a higher likelihood of unhealthy alcohol use (prevalence ratio [PR] = 1.06, 95% CI [1.05, 1.07]), severe unhealthy alcohol use (PR = 1.14, 95% CI [1.12, 1.15]), HED (PR = 1.04, 95% CI [1.03, 1.05]), AUD (PR = 1.14, 95% CI [1.13, 1.15]), and alcohol-specific conditions (PR = 1.21, 95% CI [1.18, 1.24]). Associations were larger for Black and American Indian/Alaska Native patients compared with White patients and for urban compared with rural patients. There was mixed evidence of moderation by gender. CONCLUSIONS Neighborhood disadvantage may play a role in unhealthy alcohol use in VA patients, particularly those of marginalized racialized groups and those residing in urban areas.
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Affiliation(s)
- Amy T. Edmonds
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
- Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
| | - Isaac C. Rhew
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Jessica Jones-Smith
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, Washington
| | - Kwun C. G. Chan
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - A. B. De Castro
- Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington
| | - Anna D. Rubinsky
- Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - John R. Blosnich
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California
- Health Services Research & Development, Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
| | - Emily C. Williams
- Department of Health Systems and Population Health, School of Public Health, University of Washington, Seattle, Washington
- Health Services Research & Development, Center of Innovation for Veteran-Centered and Value-Driven Care, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
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23
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Matson PA, Stankov I, Hassmiller Lich K, Flessa S, Lowy J, Thornton RLJ. A systems framework depicting how complex neighborhood dynamics and contextual factors could impact the effectiveness of an alcohol outlet zoning policy. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 70:18-32. [PMID: 34784432 DOI: 10.1002/ajcp.12566] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 09/18/2021] [Accepted: 10/06/2021] [Indexed: 06/13/2023]
Abstract
An updated zoning policy eliminating all alcohol outlets (liquor stores) in residential districts was implemented to reduce high rates of violent crime in Baltimore City. Diverse stakeholders were engaged in group model building (GMB) activities to develop causal loop diagrams (CLDs) that elucidate the impact of the new zoning policy on crime, and more broadly, the potentially unintended social and environmental consequences of the policy. Three distinct groups, community advocates, city officials/academics, and community residents, participated in three separate GMB sessions. Three CLDs, one from each stakeholder group, were created to depict the possible outcomes of the zoning policy. Our findings offer insight into potential unintended consequences of removing liquor stores from residential areas that may undermine the policy. Community members described the need for additional supports related to mental health and substance use, opportunities for investment in the community, access to other goods and services, and community-police relations to ensure the policy achieved its intended goal of reducing violent crime. Our findings highlight the importance of timely engagement of local stakeholders to understand how complex neighborhood dynamics and contextual factors could impact the effectiveness of a zoning policy change.
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Affiliation(s)
- Pamela A Matson
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ivana Stankov
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah Flessa
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Jacob Lowy
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Rachel L J Thornton
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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24
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Dee EC, Pierce LJ, Winkfield KM, Lam MB. In pursuit of equity in cancer care: moving beyond the Affordable Care Act. Cancer 2022; 128:3278-3283. [PMID: 35818772 DOI: 10.1002/cncr.34346] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 04/25/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022]
Abstract
Although Medicaid Expansion under the Patient Protection and Affordable Care Act (ACA) has been associated with many improvements for patients with cancer, Snyder et al. provide evidence demonstrating the persistence of racial disparities in cancer. This Editorial describes why insurance coverage alone does not ensure access to health care, highlights various manifestations of structural racism that constitute barriers to access beyond the direct costs of care, and calls for not just equality, but equity, in cancer care.
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Affiliation(s)
- Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Lori J Pierce
- Department of Radiation Oncology, Rogel Comprehensive Cancer Center, Michigan Medicine, Ann Arbor, Michigan, USA
| | - Karen M Winkfield
- Meharry-Vanderbilt Alliance, Department of Radiation Oncology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Miranda B Lam
- Department of Radiation Oncology, Brigham and Women's Hospital/Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Department of Health Policy and Management, Harvard School of Public Health, Boston, Massachusetts, USA
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25
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Nogueira L, White KE, Bell B, Alegria KE, Bennett G, Edmondson D, Epel E, Holman EA, Kronish IM, Thayer J. The Role of Behavioral Medicine in Addressing Climate Change-Related Health Inequities. Transl Behav Med 2022; 12:526-534. [PMID: 35613004 PMCID: PMC9132203 DOI: 10.1093/tbm/ibac005] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Climate change is the greatest threat to global health in human history. It has been declared a public health emergency by the World Health Organization and leading researchers from academic institutions around the globe. Structural racism disproportionately exposes communities targeted for marginalization to the harmful consequences of climate change through greater risk of exposure and sensitivity to climate hazards and less adaptive capacity to the health threats of climate change. Given its interdisciplinary approach to integrating behavioral, psychosocial, and biomedical knowledge, the discipline of behavioral medicine is uniquely qualified to address the systemic causes of climate change-related health inequities and can offer a perspective that is currently missing from many climate and health equity efforts. In this article, we summarize relevant concepts, describe how climate change and structural racism intersect to exacerbate health inequities, and recommend six strategies with the greatest potential for addressing climate-related health inequities.
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Affiliation(s)
| | | | | | | | | | | | - Elissa Epel
- University of California-San Francisco, San Francisco, CA, USA
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Larrabee Sonderlund A, Charifson M, Schoenthaler A, Carson T, Williams NJ. Racialized economic segregation and health outcomes: A systematic review of studies that use the Index of Concentration at the Extremes for race, income, and their interaction. PLoS One 2022; 17:e0262962. [PMID: 35089963 PMCID: PMC8797220 DOI: 10.1371/journal.pone.0262962] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/09/2022] [Indexed: 11/19/2022] Open
Abstract
Extensive research shows that residential segregation has severe health consequences for racial and ethnic minorities. Most research to date has operationalized segregation in terms of either poverty or race/ethnicity rather than a synergy of these factors. A novel version of the Index of Concentration at the Extremes (ICERace-Income) specifically assesses racialized economic segregation in terms of spatial concentrations of racial and economic privilege (e.g., wealthy white people) versus disadvantage (e.g., poor Black people) within a given area. This multidimensional measure advances a more comprehensive understanding of residential segregation and its consequences for racial and ethnic minorities. The aim of this paper is to critically review the evidence on the association between ICERace-Income and health outcomes. We implemented the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct a rigorous search of academic databases for papers linking ICERace-Income with health. Twenty articles were included in the review. Studies focused on the association of ICERace-Income with adverse birth outcomes, cancer, premature and all-cause mortality, and communicable diseases. Most of the evidence indicates a strong association between ICERace-Income and each health outcome, underscoring income as a key mechanism by which segregation produces health inequality along racial and ethnic lines. Two of the reviewed studies examined racial disparities in comorbidities and health care access as potential explanatory factors underlying this relationship. We discuss our findings in the context of the extant literature on segregation and health and propose new directions for future research and applications of the ICERace-Income measure.
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Affiliation(s)
- Anders Larrabee Sonderlund
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mia Charifson
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, United States of America
| | - Antoinette Schoenthaler
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York, New York, United States of America
| | - Traci Carson
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York, New York, United States of America
| | - Natasha J. Williams
- Center for Healthful Behavior Change, Institute for Excellence in Health Equity, New York, New York, United States of America
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Huang SJ, Sehgal NJ. Association of historic redlining and present-day health in Baltimore. PLoS One 2022; 17:e0261028. [PMID: 35045092 PMCID: PMC8769359 DOI: 10.1371/journal.pone.0261028] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In the 1930s, the Home Owners' Loan Corporation categorized neighborhoods by investment grade along racially discriminatory lines, a process known as redlining. Although other authors have found associations between Home Owners' Loan Corporation categories and current impacts on racial segregation, analysis of current health impacts rarely use these maps. OBJECTIVE To study whether historical redlining in Baltimore is associated with health impacts today. APPROACH Fifty-four present-day planning board-defined community statistical areas are assigned historical Home Owners' Loan Corporation categories by area predominance. Categories are red ("hazardous"), yellow ("definitely declining") with blue/green ("still desirable"/"best") as the reference category. Community statistical area life expectancy is regressed against Home Owners' Loan Corporation category, controlling for median household income and proportion of African American residents. CONCLUSION Red categorization is associated with 4.01 year reduction (95% CI: 1.47, 6.55) and yellow categorization is associated with 5.36 year reduction (95% CI: 3.02, 7.69) in community statistical area life expectancy at baseline. When controlling for median household income and proportion of African American residents, red is associated with 5.23 year reduction (95% CI: 3.49, 6.98) and yellow with 4.93 year reduction (95% CI: 3.22, 6.23). Results add support that historical redlining is associated with health today.
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Affiliation(s)
- Shuo Jim Huang
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Maryland, United States of America
| | - Neil Jay Sehgal
- Department of Health Policy and Management, University of Maryland School of Public Health, College Park, Maryland, United States of America
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Wright E, Waterman PD, Testa C, Chen JT, Krieger N. OUP accepted manuscript. JNCI Cancer Spectr 2022; 6:6531976. [PMID: 35603845 PMCID: PMC8953461 DOI: 10.1093/jncics/pkac016] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 10/02/2021] [Accepted: 11/29/2021] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion
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Affiliation(s)
- Emily Wright
- Correspondence to: Emily Wright, BA, PhD(c), Department of Social and Behavioral Sciences, Kresge 7th floor, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA (e-mail: )
| | | | - Christian Testa
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jarvis T Chen
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Nancy Krieger
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Siegel SD, Brooks MM, Sims-Mourtada J, Schug ZT, Leonard DJ, Petrelli N, Curriero FC. A Population Health Assessment in a Community Cancer Center Catchment Area: Triple negative breast cancer, alcohol use, and obesity in New Castle County, Delaware. Cancer Epidemiol Biomarkers Prev 2021; 31:108-116. [PMID: 34737210 DOI: 10.1158/1055-9965.epi-21-1031] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 10/12/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The National Cancer Institute (NCI) requires designated cancer centers to conduct catchment area assessments to guide cancer control and prevention efforts designed to reduce the local cancer burden. We extended and adapted this approach to a community cancer center catchment area with elevated rates of triple negative breast cancer (TNBC). METHODS Cancer registry data for 462 TNBC and 2,987 Not-TNBC cases diagnosed between 2012 and 2020 at the Helen F. Graham Cancer Center & Research Institute (HFGCCRI), located in New Castle County, Delaware, were geocoded to detect areas of elevated risk ('hot spots') and decreased risk ('cold spots'). Next, electronic health record (EHR) data on obesity and alcohol use disorder (AUD) and catchment-area measures of fast-food and alcohol retailers were used to assess for spatial relationships between TNBC hot spots and potentially modifiable risk factors. RESULTS Two hot and two cold spots were identified for TNBC within the catchment area. The hot spots accounted for 11% of the catchment area but nearly a third of all TNBC cases. Higher rates of unhealthy alcohol use and obesity were observed within the hot spots. CONCLUSIONS The use of spatial methods to analyze cancer registry and other secondary data sources can inform cancer control and prevention efforts within community cancer center catchment areas, where limited resources can preclude the collection of new primary data. IMPACT Targeting community outreach and engagement activities to TNBC hot spots offers the potential to reduce the population-level burden of cancer efficiently and equitably.
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Affiliation(s)
- Scott D Siegel
- Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System
| | | | | | | | - Dawn J Leonard
- Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System
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Swan JE, Aldridge A, Joseph V, Tucker JA, Witkiewitz K. Individual and Community Social Determinants of Health and Recovery from Alcohol Use Disorder Three Years following Treatment. J Psychoactive Drugs 2021; 53:394-403. [PMID: 34727839 DOI: 10.1080/02791072.2021.1986243] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Prior research on recovery from alcohol use disorder (AUD) has often focused on individual-level factors that promote recovery. Given systemic health inequities, it is also important to study community-level social determinants of health (SDOH) that may promote recovery from AUD. This study extended prior work examining individual profiles of recovery from AUD to assess how individual and community SDOH at the time of treatment entry were associated with recovery from AUD three years after treatment. Data were utilized from the COMBINE study (n = 664), a multisite randomized clinical trial evaluating pharmacological and behavioral treatments for AUD. Public community data sources associated with participants' study sites were used to measure community SDOH. Multilevel latent profile analyses with individual- and community-level variables as predictors of recovery profiles were estimated. Four profiles were identified based on participants' alcohol consumption and functioning. Individual SDOH variables, such as fewer years of education and lower income, and community SDOH, including lower rates of health insurance, lower income, and greater income inequality, were each associated with lower functioning profiles. The findings highlight the importance of community SDOH in AUD recovery and the value of including both individual and community SDOH variables in research on long-term recovery.
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Affiliation(s)
- Julia E Swan
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Arnie Aldridge
- Behavioral Health Financing, Economics and Evaluation Department, RTI International, Research Triangle Park, NC, USA
| | - Verlin Joseph
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
| | - Jalie A Tucker
- Center for Behavioral Economic Health Research, University of Florida, Gainesville, FL, USA
| | - Katie Witkiewitz
- Center on Alcohol, Substance Use, and Addictions and Department of Psychology, University of New Mexico, Albuquerque, NM, USA
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Trangenstein PJ, Mulia N, Lui CK, Karriker-Jaffe KJ, Greenfield TK, Jones-Webb R. Support for Alcohol Policies in Marginalized Populations. Alcohol Alcohol 2021; 56:500-509. [PMID: 33341875 PMCID: PMC8243274 DOI: 10.1093/alcalc/agaa130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 11/14/2022] Open
Abstract
AIM Kingdon [(2014) Agendas, Alternatives, and Public Policies. Essex. United Kingdom: Pearson Education Limited] argues that windows of opportunity to pass policies emerge when problems, solutions and policy support co-occur. This study aims to identify a set of alcohol policies with the potential to reduce alcohol-related disparities given high levels of support from marginalized groups, such as racial/ethnic minorities and lower-income groups. METHODS This study used data from five US National Alcohol Surveys, which were based on household probability samples of adults in 1995 (n = 4243), 2000 (n = 5736), 2005 (n = 1445), 2010 (n = 4164) and 2015 (n = 4041). We used multiple logistic regression to determine the odds of policy support by racial/ethnic group and income level, considering price, place and marketing policies as well as individual-level interventions. RESULTS Overall a majority of Americans supported banning alcohol sales in corner stores (59.4%), banning alcohol advertisements on television (55.5%), and establishing universal health coverage for alcohol treatment (80.0%). Support was particularly high among Blacks, Hispanics/Latinos and lower-income persons. Multivariate models showed that compared with White people, foreign-born Hispanics/Latinos had the most robust levels of support, including raising alcohol taxes (aOR = 2.40, 95% CI: 2.00, 2.88, P < 0.0001), banning alcohol sales in corner stores (aOR = 2.85, 95% CI: 2.22, 3.65, P < 0.0001) and reducing retail sales hours (aOR = 2.91, 95% CI: 2.38, 3.55, P < 0.0001). CONCLUSION Of the policies examined, banning alcohol sales at corner stores is most likely to be in a "window of opportunity" for reducing alcohol-related disparities. By simultaneously reducing population-level consumption and harms from others' drinking, place-based policies have the potential to reduce harms experienced by marginalized groups.
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Affiliation(s)
- Pamela J Trangenstein
- University of North Carolina at Chapel Hill, Department of Health Behavior, 135 Dauer Drive, Chapel Hill, NC 27599, USA
| | - Nina Mulia
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Camillia K Lui
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Katherine J Karriker-Jaffe
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Thomas K Greenfield
- Alcohol Research Group, Public Health Institute, 6001 Shellmound St., Suite 450, Emeryville, CA 94608, USA
| | - Rhonda Jones-Webb
- University of Minnesota, Division of Epidemiology and Community Health, 300 West Bank Office Building, Minneapolis, MN 55454, USA
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Hussaini SMQ. A prescription for fair housing during the COVID-19 pandemic. THE LANCET. INFECTIOUS DISEASES 2021; 21:903-905. [PMID: 34048710 PMCID: PMC8443067 DOI: 10.1016/s1473-3099(21)00257-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Accepted: 04/09/2021] [Indexed: 01/12/2023]
Affiliation(s)
- Syed M Qasim Hussaini
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins Medicine, Baltimore, MD 21231, USA.
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Lynch EE, Malcoe LH, Laurent SE, Richardson J, Mitchell BC, Meier HCS. The legacy of structural racism: Associations between historic redlining, current mortgage lending, and health. SSM Popul Health 2021; 14:100793. [PMID: 33997243 PMCID: PMC8099638 DOI: 10.1016/j.ssmph.2021.100793] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/16/2021] [Accepted: 04/02/2021] [Indexed: 11/02/2022] Open
Abstract
Structural racism, which is embedded in past and present operations of the U.S. housing market, is a fundamental cause of racial health inequities. We conducted an ecologic study to 1) examine historic redlining in relation to current neighborhood lending discrimination and three key indicators of societal health (mental health, physical health, and infant mortality rate (IMR)) and 2) investigate sustained lending disinvestment as a determinant of current neighborhood health in one of the most hypersegregated metropolitan areas in the United States, Milwaukee, Wisconsin. We calculated weighted historic redlining scores from the proportion of 1930s Home Owners' Loan Corporation residential security grades contained within 2010 census tract boundaries. We combined two lending indicators from 2018 Home Mortgage Disclosure Act data to capture current neighborhood lending discrimination: low lending occurrence and high cost loans (measured via loan rate spread). Using historic redlining score and current lending discrimination, we created a 4-level hierarchical measure of lending trajectory. In Milwaukee neighborhoods, greater historic redlining was associated with current lending discrimination (OR = 1.73, 95%CI: 1.16, 2.58) and increased prevalence of poor physical health (β = 1.34, 95%CI: 0.40, 2.28) and poor mental health (β = 1.26, 95%CI: 0.51, 2.01). Historic redlining was not associated with neighborhood IMR (β = -0.48, 95%CI: -2.12, 1.15). A graded association was observed between lending trajectory and health: neighborhoods with high sustained disinvestment had worse physical and mental health than neighborhoods with high investment (poor physical health: β = 5.33, 95%CI: 3.05, 7.61; poor mental health: β = 4.32, 95%CI: 2.44, 6.20). IMR was highest in 'disinvested' neighborhoods (β = 5.87, 95%CI: 0.52, 11.22). Our findings illustrate ongoing legacies of government sponsored historic redlining. Structural racism, as manifested in historic and current forms of lending disinvestment, predicts poor health in Milwaukee's hypersegregated neighborhoods. We endorse equity focused policies that dismantle and repair the ways racism is entrenched in America's social fabric.
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Affiliation(s)
- Emily E Lynch
- Joseph J. Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Lorraine Halinka Malcoe
- Joseph J. Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | - Sarah E Laurent
- Joseph J. Zilber School of Public Health, University of Wisconsin - Milwaukee, Milwaukee, WI, USA
| | | | | | - Helen C S Meier
- Population, Neurodevelopment, and Genetics Program, Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
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Molina-de la Fuente I, Pastor A, Conde P, Sandín Vázquez M, Ramos C, Bosque-Prous M, Franco M, Sureda X. Residents perceptions of the alcohol environment: A participatory photovoice project in two districts with different socio-economic status in a large city. Health Place 2021; 69:102566. [PMID: 33873132 DOI: 10.1016/j.healthplace.2021.102566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 02/04/2023]
Abstract
The purpose of this study was to present the alcohol environment as perceived by its residents in two districts of Madrid using the Photovoice participatory methodology. Secondly, we compared the results according to the socio-economic status of the districts. The study was conducted in the city of Madrid, Spain, in two districts with different socio-economic status. A total of 26 people participated, who took and discussed photographs about their alcohol environment. They grouped them into 33 final categories, such as the socialising role of alcohol or the alcohol advertising. Co-authors further grouped participants final categories into seven general areas. The participants in the Photovoice project have helped to deepen the understanding of the alcohol urban environment. These results may help to design more effective policies to prevent hazardous alcohol consumption.
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Affiliation(s)
- Irene Molina-de la Fuente
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Biomedicine and Biotechnology, University of Alcalá, Alcalá de Henares, Madrid, Spain; Malaria and Neglected Diseases Laboratory, National Centre of Tropical Medicine, Institute of Health Carlos III, Madrid, 28029, Spain
| | - Andrea Pastor
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - Paloma Conde
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain
| | - María Sandín Vázquez
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Community Health and Social Sciences, Graduate School of Public Health and Health Policy, City University of New York, New York, USA
| | - Carmen Ramos
- Public Health Institute of Madrid, Madrid City Council, 28007, Madrid, Spain
| | - Marina Bosque-Prous
- Faculty of Health Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
| | - Manuel Franco
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health. 615 North Wolfe Street, Baltimore, 21205, Maryland, USA
| | - Xisca Sureda
- Public Health and Epidemiology Research Group, School of Medicine, University of Alcalá, Alcalá de Henares, Madrid, 28871, Spain; Department of Epidemiology & Biostatistics, Graduate School of Public Health & Health Policy, City University of New York, New York, NY, 10027, USA; Tobacco Control Research Group, Institut D'Investigació Biomèdica de Bellvitge-IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Consortium for Biomedical Research in Respirarory Diseases (CIBER en Enfermedades Respiratorias, CIBERES), Madrid, Spain.
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Schwartz E, Onnen N, Craigmile PF, Roberts ME. The legacy of redlining: Associations between historical neighborhood mapping and contemporary tobacco retailer density in Ohio. Health Place 2021; 68:102529. [PMID: 33631601 PMCID: PMC8651150 DOI: 10.1016/j.healthplace.2021.102529] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 01/28/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
In the 1930s United States, urban neighborhoods were graded on their desirability for investment (often based on race), a process known as "redlining." This study examined how historical redlining relates to current disparities in an important health determinant: tobacco retailer density. Analyses were conducted for thirteen Ohio cities using negative binomial models that accounted for retailer spatial dependence and controlled for present-day sociodemographic characteristics. Findings indicated that as grades increased from "Best" to "Still Desirable" to "Definitely Declining" and "Hazardous," retailer density increased monotonically. These results highlight the persisting impacts of redlining and how disparities, once intentionally created, can be perpetuated over time.
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Affiliation(s)
- Elli Schwartz
- College of Public Health, The Ohio State University, Columbus, OH, USA
| | - Nathaniel Onnen
- Department of Statistics, The Ohio State University, Columbus, OH, USA
| | - Peter F Craigmile
- Department of Statistics, The Ohio State University, Columbus, OH, USA
| | - Megan E Roberts
- College of Public Health, The Ohio State University, Columbus, OH, USA.
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Krieger N, Wright E, Chen JT, Waterman PD, Huntley ER, Arcaya M. Cancer Stage at Diagnosis, Historical Redlining, and Current Neighborhood Characteristics: Breast, Cervical, Lung, and Colorectal Cancers, Massachusetts, 2001-2015. Am J Epidemiol 2020; 189:1065-1075. [PMID: 32219369 PMCID: PMC7666416 DOI: 10.1093/aje/kwaa045] [Citation(s) in RCA: 120] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2019] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 01/21/2023] Open
Abstract
In the 1930s, maps created by the federal Home Owners’ Loan Corporation (HOLC) nationalized residential racial segregation via “redlining,” whereby HOLC designated and colored in red areas they deemed to be unsuitable for mortgage lending on account of their Black, foreign-born, or low-income residents. We used the recently digitized HOLC redlining maps for 28 municipalities in Massachusetts to analyze Massachusetts Cancer Registry data for late stage at diagnosis for cervical, breast, lung, and colorectal cancer (2001–2015). Multivariable analyses indicated that, net of age, sex/gender, and race/ethnicity, residing in a previously HOLC-redlined area imposed an elevated risk for late stage at diagnosis, even for residents of census tracts with present-day economic and racial privilege, whereas the best historical HOLC grade was not protective for residents of census tracts without such current privilege. For example, a substantially elevated risk of late stage at diagnosis occurred among men with lung cancer residing in currently privileged areas that had been redlined (risk ratio = 1.17, 95% confidence interval: 1.06, 1.29), whereas such risk was attenuated among men residing in census tracts lacking such current privilege (risk ratio = 1.01, 95% confidence interval: 0.94, 1.08). Research on historical redlining as a structural driver of health inequities is warranted.
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Affiliation(s)
- Nancy Krieger
- Correspondence to Dr. Nancy Krieger, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA 02115 (e-mail: )
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Milam AJ, Barajas CB, Buchalski Z, Wang L, Sadler R, Furr-Holden CDM. Discrepancies in Local, State, and National Alcohol Outlet Listings: Implications for Research and Interventions. Subst Use Misuse 2020; 55:2348-2356. [PMID: 32917123 PMCID: PMC7644371 DOI: 10.1080/10826084.2020.1817080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The availability of local, state, and national data on alcohol outlet density have important implications for policies and interventions aiming to reduce alcohol-related problems. High-quality data on locations of alcohol outlets is important to accurately inform community interventions and public health initiatives, but such data is often not maintained, readily available, or of sufficient quality. Objectives: This study aims to examine the discrepancies between alcohol outlet databases and how neighborhood characteristics (i.e. income, majority racial population, urbanicity) are associated with the discrepancies between databases. Methods: Data was collected from national (n = 1), local (n = 2), and state databases (n = 3). Negative binomial regression models were used to assess discrepancies in alcohol outlet count at the ZIP code level based on the data source. Results: The average density of alcohol outlets (per 1000 residents) ranged from 0.71 to 2.17 in Maryland, 1.65 to 5.17 in Wisconsin, and 1.09 to 1.22 in Oregon based on different sources of data. Findings suggest high income areas (>200% poverty level) have fewer discrepancies (IR = 0.775, p < 0.01), low income areas (below poverty level) have greater discrepancies (IR = 4.990, p < 0.01), and urban areas tend to have fewer discrepancies (IR = 0.378, p < 0.01) between datasets. Conclusion: Interventions and policies depend on valid and reliable data; researchers, policymakers, and local agencies need to collaborate to develop methods to maintain accurate and accessible data.
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Affiliation(s)
- Adam J. Milam
- College of Human Medicine Division of Public Health, Michigan State University, Flint, U.S
- Bloomberg School of Public Health, Department of Mental Health, Johns Hopkins University, Baltimore, U.S
| | - Clara B. Barajas
- College of Human Medicine Division of Public Health, Michigan State University, Flint, U.S
| | - Zachary Buchalski
- College of Human Medicine Division of Public Health, Michigan State University, Flint, U.S
| | - Ling Wang
- College of Human Medicine Department of Medicine, Michigan State University, East Lansing, U.S
| | - Richard Sadler
- College of Human Medicine Division of Public Health, Michigan State University, Flint, U.S
| | - C Debra M. Furr-Holden
- College of Human Medicine Division of Public Health, Michigan State University, Flint, U.S
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Scott J, Danos D, Collins R, Simonsen N, Leonardi C, Scribner R, Herd D. Structural racism in the built environment: Segregation and the overconcentration of alcohol outlets. Health Place 2020; 64:102385. [PMID: 32755812 PMCID: PMC7531907 DOI: 10.1016/j.healthplace.2020.102385] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 06/22/2020] [Accepted: 06/25/2020] [Indexed: 11/17/2022]
Abstract
Structural racism, evidenced in practices like residential racial segregation, has been linked to health inequities. We examined the relationship between an adverse environmental factor (alcohol outlet overconcentration), segregated neighborhoods, and county alcohol policy in Louisiana and Alabama to investigate this link. Multilevel analysis revealed high outlet density associated with segregated counties and predominantly black census tracts in counties with restrictive alcohol policy. This inverse association between policies designed to limit alcohol availability and overconcentration of outlets in black neighborhoods warrants consideration by policymakers given links between outlet density and health inequities. Consideration of these findings in historical context suggests these policies may function as a contemporary actualization of the historical use of alcohol policy to subjugate black people in the South, now over-concentrating instead of prohibiting access.
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Affiliation(s)
| | - Denise Danos
- Louisiana State University Health Sciences Center, School of Public Health, USA
| | | | - Neal Simonsen
- Louisiana State University Health Sciences Center, School of Public Health, USA
| | - Claudia Leonardi
- Louisiana State University Health Sciences Center, School of Public Health, USA
| | | | - Denise Herd
- University of California, School of Public Health, Berkeley, USA
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Krieger N, Van Wye G, Huynh M, Waterman PD, Maduro G, Li W, Gwynn RC, Barbot O, Bassett MT. Structural Racism, Historical Redlining, and Risk of Preterm Birth in New York City, 2013-2017. Am J Public Health 2020; 110:1046-1053. [PMID: 32437270 PMCID: PMC7287548 DOI: 10.2105/ajph.2020.305656] [Citation(s) in RCA: 228] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2020] [Indexed: 11/04/2022]
Abstract
Objectives. To assess if historical redlining, the US government's 1930s racially discriminatory grading of neighborhoods' mortgage credit-worthiness, implemented via the federally sponsored Home Owners' Loan Corporation (HOLC) color-coded maps, is associated with contemporary risk of preterm birth (< 37 weeks gestation).Methods. We analyzed 2013-2017 birth certificate data for all singleton births in New York City (n = 528 096) linked by maternal residence at time of birth to (1) HOLC grade and (2) current census tract social characteristics.Results. The proportion of preterm births ranged from 5.0% in grade A ("best"-green) to 7.3% in grade D ("hazardous"-red). The odds ratio for HOLC grade D versus A equaled 1.6 and remained significant (1.2; P < .05) in multilevel models adjusted for maternal sociodemographic characteristics and current census tract poverty, but was 1.07 (95% confidence interval = 0.92, 1.20) after adjustment for current census tract racialized economic segregation.Conclusions. Historical redlining may be a structural determinant of present-day risk of preterm birth.Public Health Implications. Policies for fair housing, economic development, and health equity should consider historical redlining's impacts on present-day residential segregation and health outcomes.
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Affiliation(s)
- Nancy Krieger
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Gretchen Van Wye
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Mary Huynh
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Pamela D Waterman
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Gil Maduro
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Wenhui Li
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - R Charon Gwynn
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Oxiris Barbot
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
| | - Mary T Bassett
- Nancy Krieger and Pamela D. Waterman are with the Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health (HSPH), Boston, MA. Gretchen Van Wye is with the Bureau of Vital Statistics, New York City Department of Health and Mental Hygiene (NYC DOHMH), New York, NY. Mary Huynh is with the Office of Vital Statistics, NYC DOHMH. Gil Maduro is with the commissioner's office, NYC DOHMH. Wenhui Li is with the Statistical Analysis and Reporting Unit, NYC DOHMH. R. Charon Gwynn is with the Division of Epidemiology, NYC DOHMH. Oxiris Barbot is the commissioner of NYC DOHMH. At the time of the initial conceptualization of this work, Mary T. Bassett was the commissioner of the NYC DOHMH, and now is with the François-Xavier Bagnoud Center for Health and Human Rights and Department of Social and Behavioral Science, HSPH
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Phan L, Yu W, Keralis JM, Mukhija K, Dwivedi P, Brunisholz KD, Javanmardi M, Tasdizen T, Nguyen QC. Google Street View Derived Built Environment Indicators and Associations with State-Level Obesity, Physical Activity, and Chronic Disease Mortality in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103659. [PMID: 32456114 PMCID: PMC7277659 DOI: 10.3390/ijerph17103659] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 05/17/2020] [Accepted: 05/20/2020] [Indexed: 11/21/2022]
Abstract
Previous studies have demonstrated that there is a high possibility that the presence of certain built environment characteristics can influence health outcomes, especially those related to obesity and physical activity. We examined the associations between select neighborhood built environment indicators (crosswalks, non-single family home buildings, single-lane roads, and visible wires), and health outcomes, including obesity, diabetes, cardiovascular disease, and premature mortality, at the state level. We utilized 31,247,167 images collected from Google Street View to create indicators for neighborhood built environment characteristics using deep learning techniques. Adjusted linear regression models were used to estimate the associations between aggregated built environment indicators and state-level health outcomes. Our results indicated that the presence of a crosswalk was associated with reductions in obesity and premature mortality. Visible wires were associated with increased obesity, decreased physical activity, and increases in premature mortality, diabetes mortality, and cardiovascular mortality (however, these results were not significant). Non-single family homes were associated with decreased diabetes and premature mortality, as well as increased physical activity and park and recreational access. Single-lane roads were associated with increased obesity and decreased park access. The findings of our study demonstrated that built environment features may be associated with a variety of adverse health outcomes.
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Affiliation(s)
- Lynn Phan
- Department of Public Health Science, University of Maryland School of Public Health, College Park, MA 20742, USA
- Correspondence: (L.P.); (Q.C.N.)
| | - Weijun Yu
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
| | - Jessica M. Keralis
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
| | | | - Pallavi Dwivedi
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
| | - Kimberly D. Brunisholz
- Intermountain Healthcare Delivery Institute, Intermountain Healthcare, Murray, UT 4107, USA;
| | - Mehran Javanmardi
- Department of Electrical and Computer Engineering, Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; (M.J.); (T.T.)
| | - Tolga Tasdizen
- Department of Electrical and Computer Engineering, Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT 84112, USA; (M.J.); (T.T.)
| | - Quynh C. Nguyen
- Department of Epidemiology and Biostatistics, University of Maryland School of Public Health, College Park, MD 20742, USA; (W.Y.); (J.M.K.); (P.D.)
- Correspondence: (L.P.); (Q.C.N.)
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