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Schroeder K, Dumenci L, Day SE, Konty K, Noll JG, Henry KA, Suglia SF, Wheeler DC, Argenio K, Sarwer DB. The Association Between a Neighborhood Adverse Childhood Experiences Index and Body Mass Index Among New York City Youth. Child Obes 2024. [PMID: 38959156 DOI: 10.1089/chi.2024.0215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Background: The role of neighborhood factors in the association between adverse childhood experiences (ACEs) and body mass index (BMI) has not been widely studied. A neighborhood ACEs index (NAI) captures neighborhood environment factors associated with ACE exposure. This study examined associations between BMI and an NAI among New York City (NYC) youth. An exploratory objective examined the NAI geographic distribution across NYC neighborhoods. Methods: Data for students attending NYC public general education schools in kindergarten-12th grade from 2006-2017 (n = 1,753,867) were linked to 25 geospatial datasets capturing neighborhood characteristics for every census tract in NYC. Multivariable hierarchical linear regression tested associations between BMI and the NAI; analyses also were conducted by young (<8 years), school age (8-12 years), and adolescent (>12 years) subgroups. In addition, NAI was mapped by census tract, and local Moran's I identified clusters of high and low NAI neighborhoods. Results: Higher BMI was associated with higher NAI across all sex and age groups, with largest magnitude of associations for girls (medium NAI vs. low NAI: unstandardized β = 0.112 (SE 0.008), standardized β [effect size]=0.097, p < 0.001; high NAI vs. low NAI: unstandardized β = 0.195 (SE 0.008), standardized β = 0.178, p < 0.001) and adolescents (medium NAI vs. low NAI: unstandardized β = 0.189 (SE 0.014), standardized β = 0.161, p < 0.001, high NAI vs. low NAI: unstandardized β = 0.364 (SE 0.015), standardized β = 0.334, p < 0.001 for adolescent girls; medium NAI vs. low NAI: unstandardized β = 0.122 (SE 0.014), standardized β = 0.095, p < 0.001, high NAI vs. low NAI: unstandardized β = 0.217 (SE 0.015), standardized β = 0.187, p < 0.001 for adolescent boys). Each borough of NYC included clusters of neighborhoods with higher and lower NAI exposure, although clusters varied in size and patterns of geographic dispersion across boroughs. Conclusions: A spatial index capturing neighborhood environment factors associated with ACE exposure is associated with higher BMI among NYC youth. Findings complement prior literature about relationships between neighborhood environment and obesity risk, existing research documenting ACE-obesity associations, and the potential for neighborhood factors to be a source of adversity. Collectively, evidence suggests that trauma-informed place-based obesity reduction efforts merit further exploration as potential means to interrupt ACE-obesity associations.
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Affiliation(s)
- Krista Schroeder
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA, USA
| | - Levent Dumenci
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA, USA
| | - Sophia E Day
- Office of School Health, New York City Department of Health and Mental Hygiene, Long Island City, NY, USA
| | - Kevin Konty
- Office of School Health, New York City Department of Health and Mental Hygiene, Long Island City, NY, USA
| | - Jennie G Noll
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Kevin A Henry
- Department of Geography and Urban Studies, Temple University College of Liberal Arts, Philadelphia, PA, USA
| | - Shakira F Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | - David C Wheeler
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Kira Argenio
- Office of School Health, New York City Department of Health and Mental Hygiene, Long Island City, NY, USA
| | - David B Sarwer
- Department of Social and Behavioral Sciences, Temple University College of Public Health, Philadelphia, PA, USA
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Kondo MC, Locke D, Hazer M, Mendelson T, Fix RL, Joshi A, Latshaw M, Fry D, Mmari K. A greening theory of change: How neighborhood greening impacts adolescent health disparities. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 73:541-553. [PMID: 38303603 DOI: 10.1002/ajcp.12735] [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: 08/17/2023] [Revised: 12/15/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024]
Abstract
Neighborhoods are one of the key determinants of health disparities among young people in the United States. While neighborhood deprivation can exacerbate health disparities, amenities such as quality parks and greenspace can support adolescent health. Existing conceptual frameworks of greening-health largely focus on greenspace exposures, rather than greening interventions. In this paper, we develop and propose a Greening Theory of Change that explains how greening initiatives might affect adolescent health in deprived neighborhoods. The theory situates greening activities and possible mechanisms of change in the context of their ability to modify distal social determinants of health factors, stemming from macrostructural and historical processes that lead to resource inequalities, affecting both the social and built environment in which adolescents live and develop. The framework illustrates both short- and long-term health, economic, and security effects of greening. We also describe how the theory informed the development of Project VITAL (Vacant lot Improvement to Transform Adolescent Lives) in Baltimore, MD, which aims to (1) build a citywide sharable database on vacant lot restoration activities, (2) evaluate the impact of greening initiatives on adolescent health outcomes, (3) conduct cost-effectiveness analyses, and (4) develop best practices for greening programs for improved adolescent health.
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Affiliation(s)
- Michelle C Kondo
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Dexter Locke
- USDA Forest Service, Northern Research Station, Baltimore, Maryland, USA
| | - Meghan Hazer
- Baltimore City Department of Public Works, Office of Research and Environmental Protection, Watershed Planning + Partnerships, Baltimore, Maryland, USA
| | - Tamar Mendelson
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Rebecca L Fix
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Ashley Joshi
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Megan Latshaw
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Dustin Fry
- USDA Forest Service, Northern Research Station, Philadelphia, Pennsylvania, USA
| | - Kristin Mmari
- Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Skiendzielewski K, Forke CM, Sarwer DB, Noll JG, Wheeler DC, Henry KA, Schroeder K. The intersection of adverse childhood experiences and neighborhood determinants of health: An exploratory spatial analysis. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2024; 16:S125-S132. [PMID: 35834220 PMCID: PMC9839886 DOI: 10.1037/tra0001320] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with elevated risk for poor physical and psychological health outcomes. Nearly all of the literature on the association between ACEs and poor health focuses on the individual and family level; the potential role of neighborhood environment is overlooked. Understanding the relationship between ACEs and characteristics of the neighborhood environment is a necessary first step in determining if and how place-based, trauma-informed interventions might mitigate the negative effects of ACEs. The purpose of this exploratory study was to describe the neighborhood environment of adults who have experienced ≥ 4 versus ≤ 3 ACEs. METHOD An exploratory secondary analysis of cross-sectional and geospatial data was conducted during 2021. Data sources included 2011/2012 Philadelphia ACE Survey data, a telephone survey of 1,784 randomly sampled Philadelphia adults, linked with geospatial data on 21 neighborhood-level determinants of health. Neighborhood was defined as participant's home census tract at the time of survey. The sample for this secondary analysis included the 1,679 Philadelphia ACE Survey participants for whom home census tract was available. Bivariate logistic regression examined differences between groups (≤ 3 ACEs vs. ≥ 4 ACEs). RESULTS Individuals with ≥ 4 ACEs lived in neighborhoods with higher neighborhood poverty rates, less socioeconomic resources, worse food access, poorer perceived physical and mental health, more substance overdose deaths, higher crime, and less green space. CONCLUSIONS Findings suggest future work may benefit from considering neighborhood environments when examining and intervening upon the association between ACEs and poor physical and psychological health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Christine M. Forke
- Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania
- Center for Violence Prevention, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - David B. Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Center for Obesity Research and Education, Temple University
| | - Jennie G. Noll
- Department of Human Development and Family Studies, College of Health and Human Development, Pennsylvania State University
| | - David C. Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University
| | - Kevin A. Henry
- Department of Geography and Urban Studies, College of Liberal Arts, Temple University
| | - Krista Schroeder
- Department of Nursing, College of Public Health, Temple University
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Johnston L, Jackson K, Hilton C, N H Graham Y. Mind the gap! Factors that predict progression to bariatric surgery indicate that more psychological treatment may be required. Clin Obes 2024; 14:e12626. [PMID: 38058253 DOI: 10.1111/cob.12626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/06/2023] [Accepted: 10/01/2023] [Indexed: 12/08/2023]
Abstract
In the UK, the number of adults living with obesity is increasing. Bariatric surgery is an available treatment for those living with a BMI (kg/m2 ) ≥40 and above, or ≥35 with obesity-related comorbidities. Guidelines highlight the importance of providing psychological support pre- and post-surgery owing to the complex psychopathology present in those living with obesity. There are a lack of studies examining which patients proceed to surgery and the factors that predict progression. Routine patient data were collected within one NHS regional service in the UK, comprising 733 patients between 3 August 2018 and 26 July 2019, aged between 17 and 76 years (M = 43.20, SD = 12.32). The only exclusion criteria were patients still awaiting a final decision for surgical outcome at the point of analysis (N = 29), which resulted in 704 patients included in analysis. Binary Logistic Regression revealed those who were more likely to progress to surgery had a lower-level use of maladaptive external substances; lower level of self-harm and/or suicidality, were older in age; had a lower BMI; and had less comorbidities than those who did not progress. Findings support existing literature in that bariatric patients often present with physical and mental health complexity. Two thirds of patients in this study did not progress to surgery. Service commissioning decisions meant that these patients did not have access to psychology treatment. Consequently, in cases where bariatric surgery is considered, a final treatment option and otherwise clinically appropriate, lack of access to specialist services may result in unmet patient need owing particularly to a lack of psychological treatment provision.
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Affiliation(s)
- Lynne Johnston
- Clinical Health Psychology, Golden Jubilee University National Hospital, Clydebank, UK
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Halley Johnston Associates Ltd, Whitley Bay, UK
- Department of Clinical Health Psychology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
- Faculty of Health Sciences and Wellbeing, Helen McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland, UK
| | - Kacey Jackson
- Department of Clinical Health Psychology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
- Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Charlotte Hilton
- Hilton Health Consultancy, Derbyshire, UK
- Division of Clinical Research in the College of Medicine, University of Florida, Gainsville, Florida, USA
- College of Health Psychology and Social Care, University of Derby, Derby, UK
| | - Yitka N H Graham
- Department of Clinical Health Psychology, South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
- Faculty of Health Sciences and Wellbeing, Helen McArdle Nursing and Care Research Institute, University of Sunderland, Sunderland, UK
- Faculty of Psychology, University of Anahuac Mexico, Ciudad de Mexico, Mexico
- Facultad de Ciencias Biomedicas, Universidad Austral, Buenos Aires, Argentina
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Baishya M, Zisman-Ilani Y, Hoadley A, Litsas D, Roth S, Collins BN. Urban neighbourhood elements that influence psychoactive substance use among populations with adverse childhood experiences: a scoping review protocol. BMJ Open 2023; 13:e066796. [PMID: 37197818 DOI: 10.1136/bmjopen-2022-066796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023] Open
Abstract
INTRODUCTION Adverse childhood experiences (ACEs) are stressful or traumatic events experienced before the age of 18 years old. ACEs have been associated with an increased risk for substance use in adulthood. While an abundance of research has examined psychosocial factors that explain the link between ACEs and psychoactive substance use, little is known about the additional influence of the urban neighbourhood environment, including community-level factors, that influence the risk of substance use among populations with a history of ACEs. METHODS AND ANALYSIS The following databases will be systematically searched: PubMed, Embase, Web of Science, Cochrane, PsycInfo, CINAHL, Clinicaltrials.gov and TRIP medical databases. After the title and abstract screening and full-text screening, we will also conduct a manual search of the reference sections of included articles and include relevant citations. Eligibility criteria include peer-reviewed articles that focus on populations with at least one ACE, factors from the urban neighbourhood community, such as elements from the built environment, presence of community service programmes, quality and vacancy of housing, neighbourhood level social cohesion, and neighbourhood level collective efficacy or crime. Included articles should also include terms such as 'substance abuse', 'prescription misuse' and 'dependence'. Only studies written or translated into the English language will be included. ETHICS AND DISSEMINATION This systematic and scoping review will focus on peer-reviewed publications and does not require ethics approval. Findings will be available for clinicians, researchers and community members via publications and social media. This protocol describes the rationale and methods for the first scoping review to inform future research and community-level intervention development that targets substance use among populations who have experienced ACEs. PROSPERO REGISTRATION NUMBER CRD42023405151.
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Affiliation(s)
- Mona Baishya
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Phildelphia, Pennsylvania, USA
| | - Yaara Zisman-Ilani
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Phildelphia, Pennsylvania, USA
| | - Ariel Hoadley
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Phildelphia, Pennsylvania, USA
| | - Diana Litsas
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Phildelphia, Pennsylvania, USA
| | - Stephanie Roth
- Junior Board Cancer Resource Library, Christiana Care, Newark, Delaware, USA
| | - Bradley N Collins
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Phildelphia, Pennsylvania, USA
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Owen C, Crane J. Trauma-Informed Design of Supported Housing: A Scoping Review through the Lens of Neuroscience. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14279. [PMID: 36361166 PMCID: PMC9658651 DOI: 10.3390/ijerph192114279] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/17/2022] [Accepted: 10/28/2022] [Indexed: 06/16/2023]
Abstract
There is growing recognition of the importance of the design of the built environment in supporting mental health. In this context, trauma-informed design has emerged as a new field of practice targeting the design of the built environment to support wellbeing and ameliorate the physical, psychological and emotional impacts of trauma and related pathologies such as Post Traumatic Stress Disorder (PTSD). With high levels of prevalence of PTSD among people escaping homelessness and domestic violence, a priority area is the identification and application of evidence-based design solutions for trauma-informed supported housing. This study sought to examine the scope of existing evidence on the relationship between trauma, housing and design and the correlation of this evidence with trauma-informed design principles, and to identify gaps and opportunities for future research. In response to the commonly articulated limitations of the evidence-base in built environment design research, we combined a scoping review of literature on trauma, housing and design with insights from neuroscience to focus and extend understanding of the opportunities of trauma-informed design. We found that while limited in scope, there is strong alignment between existing evidence and the principles of trauma-informed design. We also identify three areas of future research related to the key domains of safety and security; control; and enriched environments.
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Affiliation(s)
- Ceridwen Owen
- School of Architecture and Design, College of Sciences and Engineering, University of Tasmania, Launceston, TAS 7250, Australia
| | - James Crane
- Tasmanian School of Medicine, University of Tasmania, Hobart, TAS 7000, Australia
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Sarwer DB, Siminoff LA, Gardiner HM, Spitzer JC. The psychosocial burden of visible disfigurement following traumatic injury. Front Psychol 2022; 13:979574. [PMID: 36110275 PMCID: PMC9468754 DOI: 10.3389/fpsyg.2022.979574] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/21/2022] [Indexed: 12/15/2022] Open
Abstract
Hundreds of thousands of individuals experience traumatic injuries each year. Some are mild to moderate in nature and patients experience full functional recovery and little change to their physical appearance. Others result in enduring, if not permanent, changes in physical functioning and appearance. Reconstructive plastic surgical procedures are viable treatments options for many patients who have experienced the spectrum of traumatic injuries. The goal of these procedures is to restore physical functioning and reduce the psychosocial burden of living with an appearance that may be viewed negatively by the patient or by others. Even after receipt of reconstructive procedures, many patients are left with residual disfigurement. In some, disability and disfigurement may be so profound that individuals are candidates for vascularized composite allotransplantation (VCA) procedures, i.e., the transplantation of a vascularized human body part containing multiple tissue types (skin, muscle, bone, nerves, and blood vessels) as an anatomical and/or structural unit. This narrative review paper summarizes the literature on the psychosocial burden experienced by those who have visible disfigurement. While many of these individuals experience stigma and discrimination, relatively few studies have employed a stigma framework to understand the psychosocial sequelea. This paper briefly addresses this framework. Last, particular focus is given to the psychosocial issues of individuals with particularly severe injuries who are potential candidates for VCA procedures.
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Affiliation(s)
- David B. Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
- *Correspondence: David B. Sarwer,
| | - Laura A. Siminoff
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
| | - Heather M. Gardiner
- Department of Social and Behavioral Sciences, College of Public Health, Temple University, Philadelphia, PA, United States
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Schroeder K, Dumenci L, Sarwer DB, Noll JG, Henry KA, Suglia SF, Forke CM, Wheeler DC. The Intersection of Neighborhood Environment and Adverse Childhood Experiences: Methods for Creation of a Neighborhood ACEs Index. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137819. [PMID: 35805478 PMCID: PMC9265402 DOI: 10.3390/ijerph19137819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/16/2022]
Abstract
This study evaluated methods for creating a neighborhood adverse childhood experiences (ACEs) index, a composite measure that captures the association between neighborhood environment characteristics (e.g., crime, healthcare access) and individual-level ACEs exposure, for a particular population. A neighborhood ACEs index can help understand and address neighborhood-level influences on health among individuals affected by ACEs. Methods entailed cross-sectional secondary analysis connecting individual-level ACEs data from the Philadelphia ACE Survey (n = 1677) with 25 spatial datasets capturing neighborhood characteristics. Four methods were tested for index creation (three methods of principal components analysis, Bayesian index regression). Resulting indexes were compared using Akaike Information Criteria for accuracy in explaining ACEs exposure. Exploratory linear regression analyses were conducted to examine associations between ACEs, the neighborhood ACEs index, and a health outcome—in this case body mass index (BMI). Results demonstrated that Bayesian index regression was the best method for index creation. The neighborhood ACEs index was associated with higher BMI, both independently and after controlling for ACEs exposure. The neighborhood ACEs index attenuated the association between BMI and ACEs. Future research can employ a neighborhood ACEs index to inform upstream, place-based interventions and policies to promote health among individuals affected by ACEs.
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Affiliation(s)
- Krista Schroeder
- Department of Nursing, Temple University College of Public Health, Philadelphia, PA 19122, USA
- Correspondence:
| | - Levent Dumenci
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA 19122, USA;
| | - David B. Sarwer
- Department of Social and Behavioral Sciences, Center for Obesity Research and Education, Temple University College of Public Health, Philadelphia, PA 19122, USA;
| | - Jennie G. Noll
- Department of Human Development and Family Studies, Penn State College of Health and Human Development, University Park, PA 16802, USA;
| | - Kevin A. Henry
- Department of Geography and Urban Studies, Temple University College of Liberal Arts, Philadelphia, PA 19122, USA;
| | - Shakira F. Suglia
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA;
| | - Christine M. Forke
- Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania, Center for Violence Prevention, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA;
| | - David C. Wheeler
- Department of Biostatistics, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA;
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