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Bernard K, McGowan VJ, Bambra C. "Power, control, strain": Lay perceptions of health inequalities across England's 'North South divide'. Soc Sci Med 2024; 355:117089. [PMID: 39024711 DOI: 10.1016/j.socscimed.2024.117089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 06/14/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024]
Abstract
People in the North of England live shorter, less healthy lives than those in the South. Despite the significance of this 'North South health divide', regional health inequalities in England are under-researched qualitatively. Existing literature on geographical inequalities in health is largely confined to the neighbourhood level, is quantitative, and consists of very little lay knowledge. The current study is the first to examine lay perspectives of health inequalities on a regional level: exploring how people living in two urban areas of the North and South of England experience and perceive the North South health divide - including its causes and solutions. Using three focus group discussions with a total of 34 participants, and conducting participatory analysis, we identified three key themes: 'inequalities of power', 'lack of control over lived environment' and 'communities under strain'. Findings align with existing research on lay perspectives of health inequalities at the neighbourhood level - identifying a network of material-structural and psychosocial factors. Participants across both regions discussed political and economic structures as central to understanding regional health inequalities, supporting calls to adopt a political economy approach in understanding health and place. Deindustrialisation, unemployment, loss of community facilities, and disengagement from politics were more present in Northern narratives than Southern. Findings add important 'social meaning' to emerging research on the North South health divide, reinforcing the urgency of public health professionals' recommendations for fair redistribution of power, wealth and resources to reduce regional health inequalities. In the context of government policy which diverges from public health evidence, this study sparks questions of how health inequalities research can intersect with wider social and political movements organising for systemic change.
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Affiliation(s)
- Kate Bernard
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, Newcastle-upon-Tyne, NE1 7RU, UK.
| | - Victoria J McGowan
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, Newcastle-upon-Tyne, NE1 7RU, UK.
| | - Clare Bambra
- Population Health Sciences Institute, Newcastle University, Ridley 1 Building, Newcastle-upon-Tyne, NE1 7RU, UK.
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Schnake-Mahl A, Anfuso G, Goldstein ND, Purtle J, Eberth JM, Ortigoza A, Bilal U. Measuring variation in infant mortality and deaths of despair by US congressional district in Pennsylvania: a methodological case study. Am J Epidemiol 2024; 193:1040-1049. [PMID: 38412272 DOI: 10.1093/aje/kwae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/26/2024] [Accepted: 02/22/2024] [Indexed: 02/29/2024] Open
Abstract
Many ecological studies examine health outcomes and disparities using administrative boundaries such as census tracts, counties, or states. These boundaries help us to understand the patterning of health by place, along with impacts of policies implemented at these levels. However, additional geopolitical units (units with both geographic and political meaning), such as congressional districts (CDs), present further opportunities to connect research with public policy. Here we provide a step-by-step guide on how to conduct disparities-focused analysis at the CD level. As an applied case study, we use geocoded vital statistics data from 2010-2015 to examine levels of and disparities in infant mortality and deaths of despair in the 19 US CDs of Pennsylvania for the 111th-112th (2009-2012) Congresses and 18 CDs for the 113th-114th (2013-2016) Congresses. We also provide recommendations for extending CD-level analysis to other outcomes, states, and geopolitical boundaries, such as state legislative districts. Increased surveillance of health outcomes at the CD level can help prompt policy action and advocacy and, hopefully, reduce rates of and disparities in adverse health outcomes.
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Safayet M, Casellas Connors JP, Watson M. Measuring access to food banks and food pantries: A scoping review of spatial analysis approaches. Health Place 2024; 88:103251. [PMID: 38744054 DOI: 10.1016/j.healthplace.2024.103251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Revised: 04/03/2024] [Accepted: 04/22/2024] [Indexed: 05/16/2024]
Abstract
Food banks and food pantries are crucial in supporting access to food and addressing food insecurity for millions of people. This scoping review identified eighteen articles that applied spatial analysis approaches to measure access to food banks and food pantries. The review summarizes the methods and primary findings of these studies, and examines how these address different dimensions of food access. Findings suggest that the majority of studies measured the accessibility and availability dimensions of food access, and two addressed accommodation. Through a discussion of these studies' methods and broader literature on food environments, we highlight opportunities to integrate advanced geospatial and mixed methods to support an empirically grounded and broader understanding of food bank and pantry access in future research. This will yield a more holistic picture of food environments and provide practical implications for site selection, resource allocation, and food assistance operations.
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Affiliation(s)
- Mastura Safayet
- Department of Geography, Texas A&M University, College Station, TX, USA.
| | - John P Casellas Connors
- Department of Geography, Texas A&M University, College Station, TX, USA; Hazards Reduction and Recovery Center, Texas A&M University, College Station, TX, USA.
| | - Maria Watson
- M.E. Rinker, Sr. School of Construction Management, Shimberg Center for Housing Studies, University of Florida, Gainesville, FL, USA.
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Kamis C, Xu W, Schultz A, Malecki K, Engelman M. Linking sequences of exposure to residential (dis)advantage, individual socioeconomic status, and health. Health Place 2024; 88:103262. [PMID: 38833849 DOI: 10.1016/j.healthplace.2024.103262] [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: 01/30/2024] [Revised: 04/23/2024] [Accepted: 04/30/2024] [Indexed: 06/06/2024]
Abstract
Life course theories suggest that the relationship between residential (dis)advantage and health is best understood by examining the ordering and duration of cumulative exposures across the life course. This study employs sequence and cluster analysis on two decades of residential histories linked to the Survey of the Health of Wisconsin to define typologies of exposure to residential (dis)advantage and use these typologies to predict self-rated fair/poor health. Exposure to residential (dis)advantage is mostly stable across the adult life course and greater disadvantage predicts fair/poor health. Longitudinal exposures to residential (dis)advantage shape health independently of and in tandem with individual-level resources.
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Affiliation(s)
| | - Wei Xu
- Medical College of Wisconsin, United States
| | - Amy Schultz
- University of Wisconsin- Madison, United States
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Brubacher LJ, Berrang-Ford L, Clark SN, Patterson K, Lwasa S, Namanya D, Twesigomwe S, Harper SL. Place, displacement, and health-seeking behaviour among the Ugandan Batwa: A qualitative study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003321. [PMID: 38865306 PMCID: PMC11168611 DOI: 10.1371/journal.pgph.0003321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 05/15/2024] [Indexed: 06/14/2024]
Abstract
For many Indigenous Peoples, relationships to the land are inherent in identity and culture, and to all facets of health and wellbeing, physically, emotionally, psychologically, and spiritually. The Batwa are Indigenous Peoples of rural, southwest Uganda who have experienced tremendous social and economic upheaval, due to relatively recent forced displacement and land dispossession. This loss of physical connection to their ancestral lands has significantly impacted Batwa health, and also affected available healthcare options for Batwa. This exploratory study (1) identified and characterized factors that influence Batwa health-seeking behaviour, using acute gastrointestinal illness, a critical public health issue, as a focal point for analysis; and (2) explored possible intersections between the Batwa's connection to place-and displacement-and their health-seeking behaviour for acute gastrointestinal illness. Twenty focus group discussions, stratified by gender, were conducted in ten Batwa settlements in Kanungu District, Uganda and eleven semi-structured interviews were conducted with primary healthcare workers, community health coordinators, clinical officers, and development program coordinators. Qualitative data were thematically analyzed using a constant comparative method. Batwa identified several significant motivators to engage with Indigenous and/or biomedical forms of healthcare, including transition to life outside the forest and their reflections on health in the forest; 'intellectual access' to care and generational knowledge-sharing on the use of Indigenous medicines; and Batwa identity and way of life. These nuanced explanations for health-seeking behaviour underscore the significance of place-and displacement-to Batwa health and wellbeing, and its relationship to their health-seeking behaviour for acute gastrointestinal illness. As such, the results of this study can be used to inform healthcare practice and policy and support the development of a culturally- and contextually-appropriate healthcare system, as well as to reduce the burden of acute gastrointestinal illness among Batwa.
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Affiliation(s)
- Laura Jane Brubacher
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Lea Berrang-Ford
- School of Earth and Environment, University of Leeds, Leeds, United Kingdom
| | - Sierra Nicole Clark
- Environmental and Social Epidemiology Section, Population Health Research Institute, St. George’s, University of London, London, United Kingdom
| | - Kaitlin Patterson
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
| | - Shuaib Lwasa
- Department of Geography, Makerere University, Kampala, Uganda
| | - Didacus Namanya
- Ugandan Ministry of Health, Kampala, Uganda
- Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda
| | | | | | - Sherilee L. Harper
- Department of Population Medicine, University of Guelph, Guelph, Ontario, Canada
- School of Public Health, University of Alberta, Edmonton, Alberta, Canada
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Tsimpida D, Tsakiridi A, Daras K, Corcoran R, Gabbay M. Unravelling the dynamics of mental health inequalities in England: A 12-year nationwide longitudinal spatial analysis of recorded depression prevalence. SSM Popul Health 2024; 26:101669. [PMID: 38708408 PMCID: PMC11066558 DOI: 10.1016/j.ssmph.2024.101669] [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: 04/20/2023] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 05/07/2024] Open
Abstract
Background Depression is one of the most significant public health issues, but evidence of geographic patterns and trends of depression is limited. We aimed to examine the spatio-temporal patterns and trends of depression prevalence among adults in a nationwide longitudinal spatial study in England and evaluate the influence of neighbourhood socioeconomic deprivation in explaining patterns. Methods Information on recorded depression prevalence was obtained from the indicator Quality and Outcomes Framework: Depression prevalence that measured the annual percentage of adults diagnosed with depression for Lower Super Output Areas (LSOA) from 2011 to 2022. We applied Cluster and Outlier Analysis using the Local Moran's I algorithm. Local effects of deprivation on depression in 2020 examined with Geographically Weighted Regression (GWR). Inequalities in recorded prevalence were presented using Prevalence Rate Ratios (PRR). Results The North West Region of England had the highest concentration of High-High clusters of depression, with 17.4% of the area having high values surrounded by high values in both space and time and the greatest percentage of areas with a high rate of increase (43.1%). Inequalities widened among areas with a high rate of increase in prevalence compared to those with a lower rate of increase, with the PRR increasing from 1.66 (99% CI 1.61-1.70) in 2011 to 1.81 (99% CI 1.76-1.85) by 2022. Deprivation explained 3%-39% of the variance in depression in 2020 across the country. Conclusions It is crucial to monitor depression's spatial patterns and trends and investigate mechanisms of mental health inequalities. Our findings can help identify priority areas and target prevention and intervention strategies in England. Evaluating mental health interventions in different geographic contexts can provide valuable insights to policymakers on the most effective and context-sensitive strategies, enabling them to allocate resources towards preventing the worsening of mental health inequalities.
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Affiliation(s)
- Dialechti Tsimpida
- Department of Public Health, Policy and Systems, University of Liverpool, UK
- Centre for Research on Ageing, University of Southampton, UK
- Department of Gerontology, University of Southampton, UK
| | | | - Konstantinos Daras
- Department of Public Health, Policy and Systems, University of Liverpool, UK
- National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), UK
| | - Rhiannon Corcoran
- National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), UK
- Department of Primary Care and Mental Health, University of Liverpool, UK
| | - Mark Gabbay
- National Institute for Health Research Applied Research Collaboration North West Coast (NIHR ARC NWC), UK
- Department of Primary Care and Mental Health, University of Liverpool, UK
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Berkowitz RL, Kan P, Gao X, Hailu EM, Board C, Lyndon A, Mujahid M, Carmichael SL. Assessing the relationship between census tract rurality and severe maternal morbidity in California (1997-2018). J Rural Health 2024; 40:531-541. [PMID: 38054697 PMCID: PMC11153330 DOI: 10.1111/jrh.12814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 10/22/2023] [Accepted: 11/26/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Recent studies have demonstrated an increased risk of severe maternal morbidity (SMM) for people living in rural versus urban counties. Studies have not considered rurality at the more nuanced subcounty census-tract level. This study assessed the relationship between census-tract-level rurality and SMM for birthing people in California. METHODS We used linked vital statistics and hospital discharge records for births between 1997 and 2018 in California. SMM was defined by at least 1 of 21 potentially fatal conditions and lifesaving procedures. Rural-Urban Commuting Area codes were used to characterize census tract rurality dichotomously (2-category) and at 4 levels (4-category). Covariates included sociocultural-demographic, pregnancy-related, and neighborhood-level factors. We ran a series of mixed-effects logistic regression models with tract-level clustering, reporting risk ratios and 95% confidence intervals (CIs). We used the STROBE reporting guidelines. FINDINGS Of 10,091,415 births, 1.1% had SMM. Overall, 94.3% of participants resided in urban/metropolitan and 5.7% in rural tracts (3.9% micropolitan, 0.9% small town, 0.8% rural). In 2-category models, the risk of SMM was 10% higher for birthing people in rural versus urban tracts (95% CI: 6%, 13%). In 4-category models, the risk of SMM was 16% higher in micropolitan versus metropolitan tracts (95% CI: 12%, 21%). CONCLUSION The observed rurality and SMM relationship was driven by living in a micropolitan versus metropolitan tract. Increased risk may result from resource access inequities within suburban areas. Our findings demonstrate the importance of considering rurality at a subcounty level to understand locality-related inequities in the risk of SMM.
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Affiliation(s)
- Rachel L. Berkowitz
- Department of Public Health and Recreation, College of Health and Human Sciences, San José State University, San Jose, California
| | - Peiyi Kan
- Department of Pediatrics (Neonatology), Stanford Medicine, Stanford University, Stanford, California
| | - Xing Gao
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Elleni M. Hailu
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Christine Board
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | | | - Mahasin Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California
| | - Suzan L. Carmichael
- Department of Pediatrics (Neonatology), Stanford Medicine, Stanford University, Stanford, California
- Department of Obstetrics and Gynecology (Maternal and Fetal Medicine), Stanford Medicine, Stanford University, Stanford, California
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Bardin S, Fotheringham AS. When everyone's doing it: The relative effects of geographical context and social determinants of health on teen birth rates. Health Place 2024; 87:103249. [PMID: 38685183 DOI: 10.1016/j.healthplace.2024.103249] [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: 01/29/2022] [Revised: 04/06/2024] [Accepted: 04/09/2024] [Indexed: 05/02/2024]
Abstract
Geographic disparities in teen birth rates in the U.S. persist, despite overall reductions over the last two decades. Research suggests these disparities might be driven by spatial variations in social determinants of health (SDOH). An alternative view is that "place" or "geographical context" affects teen birth rates so that they would remain uneven across the U.S. even if all SDOH were constant. We use multiscale geographically weighted regression (MGWR) to quantify the relative effects of geographical context, independent of SDOH, on county-level teen birth rates across the U.S. Findings indicate that even if all counties had identical compositions with respect to SDOH, strong geographic disparities in teen birth rates would still persist. Additionally, local parameter estimates show the relationships between several components of SDOH and teen birth rates vary over space in both direction and magnitude, confirming that global regression techniques commonly employed to examine these relationships likely obscure meaningful contextual differences in these relationships. Findings from this analysis suggest that reducing geographic disparities in teen birth rates will require not only ameliorating differences in SDOH across counties but also combating community norms that contribute to high rates of teen birth, particularly in the southern U.S. Further, the results suggest that if geographical context is not incorporated into models of SDOH, the effects of such determinants may be interpreted incorrectly.
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Affiliation(s)
- Sarah Bardin
- Spatial Analysis Research Center, School of Geographical Sciences and Urban Planning, Arizona State University, AZ, 85281, USA.
| | - A Stewart Fotheringham
- Spatial Analysis Research Center, School of Geographical Sciences and Urban Planning, Arizona State University, AZ, 85281, USA
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Biglieri S, Hartt M. The 'Double Risk' of Aging: Examining Vulnerability and (Un)supportive Built Environments in Canadian Cities. Can J Aging 2024; 43:99-113. [PMID: 37665016 DOI: 10.1017/s0714980823000429] [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: 09/05/2023] Open
Abstract
The confluence of rapid population aging and the overwhelming desire of older adults to age in place begs the question: Do our cities support the health and well-being of aging populations? Using a neighbourhood-by-neighbourhood approach, this macro-scale investigation explores the "double risk" that many older adults live with - the potential of being disadvantaged by socio-demographic risk factors (being older, living alone, low income) and by living in an unsupportive built environment. It is an integration of what we know about supportive built form for older adults and applies this knowledge to Canadian cities, using a spectrum approach to classifying built environments. We found that most older adults with socio-demographic risk factors are living in unsupportive built environments in Canada; however, the distribution between built environments along the spectrum and between municipalities reveals a variegated landscape of double risk. Previous research suggests that unsupportive built environments can be supplemented with services, small-scale improvements in the built environment, and larger-scale retrofitting of neighbourhoods. Since the spatial distribution of vulnerability varies greatly within the 33 Canadian cities analysed, it highlights the need for this kind of inquiry to target age-friendly policy interventions.
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Affiliation(s)
- Samantha Biglieri
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, ON, Canada
| | - Maxwell Hartt
- School of Urban and Regional Planning, Department of Geography and Planning, Queen's University, Kingston, ON, Canada
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Akpabio EM, Wilson NAU, Umoh EC, Udofia EIS, Udo II, Elijah E, Essien UE, Akpan ID, Umo IMB, Umoren IB, Afiko S, Ema EO. Women, water and access: inscribing gender power in and through a place. JOURNAL OF WATER AND HEALTH 2024; 22:627-638. [PMID: 38557576 DOI: 10.2166/wh.2024.362] [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] [Received: 11/04/2023] [Accepted: 02/05/2024] [Indexed: 04/04/2024]
Abstract
This paper explores the socio-cultural and gender-based dynamics associated with place values, and their implications for women's access to water through case studies of upland and riverine communities in southern Nigeria. We used a range of fieldwork methods including public meetings, focus group discussions, in-depth interviews, keen observations, key informants and other secondary sources. Our findings show that drinking water sources are a part of the many forms of visible material structures that embody and generate automatic reproduction of gender-based beliefs, attitudes, feelings and practices. The outcome of such practices affects men and women differently in relation to access, workload and capacity for hygiene and other socio-economic practices. In discussing access to essential public goods, social and economic capacities take priority focus over the impact of 'place values' either as standalone or intersectional elements. Research should be expanded to incorporate these elements and their intersectional perspectives in shaping access to water.
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Affiliation(s)
- Emmanuel M Akpabio
- Department of Geography & Natural Resources Management, University of Uyo, Akwa Ibom State, Nigeria; International Associate, UNESCO Centre for Water Law, Policy & Science, University of Dundee, Dundee, UK E-mail:
| | | | - Enobong C Umoh
- Department of Geography & Natural Resources Management, University of Uyo, Akwa Ibom State, Nigeria
| | - Eti-Ido S Udofia
- Akwa Ibom State Ministry of Rural Development & Cooperative, Idongesit Nkanga Secretariat, Uyo, Akwa Ibom State, Nigeria
| | - Ifiok I Udo
- Department of Food Science & Technology, University of Uyo, Akwa Ibom State, Nigeria
| | - Edidiong Elijah
- Department of Geography & Natural Resources Management, University of Uyo, Akwa Ibom State, Nigeria
| | - Ubong E Essien
- Department of Geography & Natural Resources Management, University of Uyo, Akwa Ibom State, Nigeria
| | - Itoro David Akpan
- Department of Geography & Natural Resources Management, University of Uyo, Akwa Ibom State, Nigeria
| | - Ini-Mfon B Umo
- Department of Health Education, Faculty of Education, University of Uyo, Akwa Ibom State, Nigeria
| | - Itoro B Umoren
- Department of Sociology & Anthropology, University of Uyo, Akwa Ibom State, Nigeria
| | - Sunday Afiko
- Sunday Afiko LP, 36B, Unit C, Ewet Housing Estate, Uyo, Akwa Ibom State, Nigeria
| | - Eti-Obong Ema
- Department of Geography & Natural Resources Management, University of Uyo, Akwa Ibom State, Nigeria
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Li J, Hirsch JA, Michael YL, Besser LM, Auchincloss AH, Hughes TM, Sánchez BN. Spatial scale effects on associations between built environment and cognitive function: Multi-Ethnic Study of Atherosclerosis. Health Place 2024; 86:103181. [PMID: 38340497 DOI: 10.1016/j.healthplace.2024.103181] [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: 09/27/2023] [Revised: 12/26/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024]
Abstract
Built environments have the potential to favorably support cognitive function. Despite growing work on this topic, most of the work has ignored variation in the spatial scale of the effect. The issue with spatial scale effects is that the size and shape of the areal unit within which built environment characteristics are measured naturally influence the built environment exposure metric and thus the estimated associations with health. We used spatial distributed lag modeling (DLM) to estimate how associations between built environment exposures (walkable destinations [WD], social destinations [SD]) and change in cognition varied across distance of these destinations from participants' residences. Cognition was assessed as maintained/improved processing speed (PS) and global cognition (GC). Person-level data from Exam 5 (2010-2012) and Exam 6 (2016-2018) of the Multi-Ethnic Study of Atherosclerosis was used (N = 1380, mean age 67). Built environment data were derived from the National Establishment Time Series. Higher availability of walkable and social destinations at closer distance from participants' residence was associated with maintained/improved PS. The adjusted associations between maintained/improved PS and destinations waned with increasing distance from the residence; associations were evident until approximately 1.9-km for WD and 1.5-km for SD. Associations were most apparent for participants living in areas with high population density. We found little evidence for associations between change in GC and built environment at any distance. These results highlight the importance of identifying appropriate spatial scale to understand the mechanisms for built environment-cognition associations.
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Affiliation(s)
- Jingjing Li
- Department of Land Resources Management, School of Public Administration, China University of Geosciences, Wuhan, Hubei, 430074, China
| | - Jana A Hirsch
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA.
| | - Yvonne L Michael
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Lilah M Besser
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Amy H Auchincloss
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC, 27109, USA
| | - Brisa N Sánchez
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, 19104, USA
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McNeil-Gauthier AL, Milot DM, Levasseur M. How environments can promote active aging: results from a case study of two municipalities in Quebec, Canada. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2024; 115:117-131. [PMID: 37589791 PMCID: PMC10853091 DOI: 10.17269/s41997-023-00806-0] [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] [Received: 05/06/2022] [Accepted: 06/16/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVES To address global aging, a paradigm shift is needed from disease prevention and treatment towards active aging, i.e., optimizing opportunities for health, participation, and security as people age. Little is known about how age-friendly environments promote active aging. This study thus aimed to explore how (through which mechanisms and in what contexts) environments can promote active aging and, specifically, positive health, social participation, and health equity. METHODS Using a realist approach and semi-structured focus groups, a case study was used in two Quebec municipalities known for best fostering active aging. Data also included participants' logbooks, sociodemographic questionnaires, municipalities' sociodemographic profiles, and policy documents. A conceptual framework and thematic content analysis were carried out. RESULTS A total of 24 participants (9 older adults, 4 health professionals, 3 community-based actors, 5 municipal employees, and 3 elected officials) took part in 5 focus groups. Regarding contexts, both cases were midsize municipalities having an income and education level higher to Quebec's averages with supportive active aging policies. Two main themes explained how the environments promoted active aging: (1) by ensuring proximity through built (urban planning), social (network structures), services (variety and availability of local and outreach resources), and organizational (active listening to older adults' needs for active aging) environments; and (2) by fostering transversality through built (universal accessibility, intergenerational spaces), social (intergenerational opportunities for social participation), and political/organizational (unified and complementary policies) environments. CONCLUSION To better promote active aging through age-friendly environments, practices should focus on fostering proximity and transversality, and act simultaneously on multiple environments.
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Affiliation(s)
- Anne-Lou McNeil-Gauthier
- Direction Régionale de Santé Publique de La Montérégie, CISSS of Montérégie Centre, Longueuil, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - David-Martin Milot
- Direction Régionale de Santé Publique de La Montérégie, CISSS of Montérégie Centre, Longueuil, QC, Canada
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Levasseur
- Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada.
- Research Centre On Aging, CIUSSS de L'Estrie-CHUS, Sherbrooke, QC, Canada.
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Barbieri A, Rossero E. "It is like post-traumatic stress disorder, but in a positive sense!": New territories of the self as inner therapeutic landscapes for youth experiencing mental ill-health. Health Place 2024; 85:103157. [PMID: 38048648 DOI: 10.1016/j.healthplace.2023.103157] [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: 02/26/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
The manuscript reports on a study conducted on a youth mental health intervention, proposing a novel framework to look at the therapeutic potential of viticultural landscapes. Drawing on care studies applied to agricultural contexts, the work explores how the attention-based practice of manual grape harvest in a specific natural and social environment can produce a "therapeutic landscape of the mind". Through ethnographic research, we investigate how the spatial and social context of the viticultural environment influences the experience of a group of young people with mental-ill health, eventually supporting their process of recovery. Findings describe how the lived experience of caring for the vines while interacting with professional winegrowers in a one-to-one relationship allows participants to explore new territories of the self. It is argued that this powerful experience is not only beneficial as it unfolds, but also at a later time. Its therapeutic potential resides in the fact that the "landscape of the mind" can be recalled by the person, while positive identities associated with it and newly discovered "ways of being" can be re-enacted. The paper furthers the reflection on place-making practices of public health services and the way they can support the identification and cultivation of enabling places, particularly for vulnerable populations (e.g. young people) that can benefit from interventions conducted in non-medical, non-stigmatizing environments. The work is the result of an interdisciplinary collaboration between a psychiatrist (designing and coordinating the intervention) and a sociologist (designing and conducting the ethnographic study).
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14
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Blanchard AK, Ansari S, Rajput R, Colbourn T, Houweling TAJ, Lorway R, Isac S, Prost A, Anthony J. 'That is because we are alone': A relational qualitative study of socio-spatial inequities in maternal and newborn health programme coverage in rural Uttar Pradesh, India. Glob Public Health 2024; 19:2348640. [PMID: 38716491 DOI: 10.1080/17441692.2024.2348640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 04/22/2024] [Indexed: 05/15/2024]
Abstract
This qualitative study was conducted in Uttar Pradesh state, India to explore how interrelated socio-economic position and spatial characteristics of four diverse villages may have influenced equity in coverage of community-based maternal and newborn health (MNH) services. We conducted social mapping and three focus group discussions in each village, among women of lower and higher socio-economic position who recently gave birth, and with community health workers (n = 134). Data were analysed in NVivo 11.0 using thematic framework analysis. The extent of socio-economic hierarchies and spatial disparateness within the village, combined with distance to larger centers, together shaped villages' level of socio-spatial remoteness. Disadvantaged socio-economic groups expressed being more often spatially isolated, with less access to infrastructure, resources or services, which was heightened if the village was physically distant from larger centers. In more socio-spatially remote villages, inequities in coverage of MNH services that disadvantaged lower socio-economic position groups were compounded as these groups more often experienced ASHA vacancies, as well as greater distance to and poorer perceived quality of health services nearest the village. The results inform a conceptual framework of 'socio-spatial remoteness' that can guide public health research and programmes to more comprehensively address health inequities within India and beyond.
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Affiliation(s)
- Andrea K Blanchard
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
| | | | | | - Tim Colbourn
- Institute for Global Health, University College London, London, UK
| | | | - Robert Lorway
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
| | - Shajy Isac
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Lucknow, India
| | - Audrey Prost
- Institute for Global Health, University College London, London, UK
| | - John Anthony
- Institute for Global Public Health, University of Manitoba, Winnipeg, Canada
- India Health Action Trust, Lucknow, India
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15
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Beck M, Martinsen B, Missel M, Simony C, Engelke E, van Manen M. Alongside: Exploring the Meaningfulness of Significant Moments in Others' Lives Through Observation and Interview. QUALITATIVE HEALTH RESEARCH 2023:10497323231210495. [PMID: 38130185 DOI: 10.1177/10497323231210495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
How do we explore the meaningfulness of others' experiences? What means do we have to access their experiencing of the world? How do we express our understandings of others' experiences of body and place without reducing them to objectification? In this methodological paper, we reflect on how we can gain valuable insights into the lived experiences of others through research activities that are conducted 'alongside' participants. Phenomenological concepts of intentionality and embodiment are considered as we draw on an empirical example of exploring the experiences of hospitalized patients with neurological diseases through observations and interviews. The aim is to unfold alongside as an epistemological stance to explore the meaning of another's lifeworld. We strive to show that personal presence and engagement within this approach contains relational, existential, and aesthetic dimensions worth considering.
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Affiliation(s)
- Malene Beck
- Department of Pediatrics, Zealand University Hospital, Region Zealand, Denmark
- Faculty of Health, Institute of the Regional Health, University of Southern Denmark, Odense, Denmark
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Bente Martinsen
- Department of People and Technology, Roskilde University, Roskilde, Denmark
| | - Malene Missel
- Department of People and Technology, Roskilde University, Roskilde, Denmark
- Department of Cardiothoracic Surgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Charlotte Simony
- Faculty of Health, Institute of the Regional Health, University of Southern Denmark, Odense, Denmark
- Research and Implementation Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Naesteved, Slagelse and Ringsted Hospital, Region Zealand, Denmark
| | - Eileen Engelke
- College of Health Professions, Lienhard School of Nursing, New York City, NY, USA
- St. John's University, Queens New York, NY, USA
| | - Michael van Manen
- Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
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Dobischok S, Carvajal JR, Turner K, Jaffe K, Lehal E, Blawatt S, Redquest C, Baltzer Turje R, McDougall P, Koch B, McDermid C, Hassan D, Harrison S, Oviedo-Joekes E. "It feels like I'm coming to a friend's house": an interpretive descriptive study of an integrated care site offering iOAT (Dr. Peter Centre). Addict Sci Clin Pract 2023; 18:73. [PMID: 38042844 PMCID: PMC10693115 DOI: 10.1186/s13722-023-00428-4] [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: 05/18/2023] [Accepted: 11/20/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND Injectable opioid agonist treatment (iOAT) has proven to be a safe and effective treatment option for severe opioid use disorder (OUD). Yet, iOAT is often isolated from other health and social services. To align with a person-centered care approach, iOAT can be embedded in sites that combine systems and services that have been historically fragmented and that address multiple comorbidities (integrated care sites). The present study investigates the addition of iOAT at an integrated care in Vancouver, British Columbia. We aimed to capture what it means for service users and service providers to incorporate iOAT in an integrated care site and describe the processes by which the site keeps people engaged. METHODS We conducted 22 interviews with 15 service users and 14 interviews with 13 service providers across two rounds of individual semi-structured interviews (Fall 2021, Summer 2022). The second interview round was precipitated by a service interruption in medication dispensation. Interview audio was recorded, transcribed, and then analysed in NVivo 1.6 following an interpretive description approach. RESULTS The emergent themes from the analysis are represented in two categories: (1) a holistic approach (client autonomy, de-medicalized care, supportive staff relationships, multiple opportunities for engagement, barriers to iOAT integration) and (2) a sense of place (physical location, social connection and community belonging, food). CONCLUSION Incorporating iOAT at an integrated care site revealed how iOAT delivery can be strengthened through its direct connection to a diverse, comprehensive network of health and social services that are provided in a community atmosphere with high quality therapeutic relationships.
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Affiliation(s)
- Sophia Dobischok
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada
- Department of Education and Counselling Psychology, McGill University, 3700 McTavish St., Montreal, QC, H3A 1Y2, Canada
| | - José R Carvajal
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada
| | - Kyle Turner
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada
| | - Kaitlyn Jaffe
- Department of Health Promotion and Policy, University of Massachusetts Amherst, 715 North Pleasant Street, Amherst, MA, 01003, USA
| | - Eisha Lehal
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada
| | - Sarinn Blawatt
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada
| | - Casey Redquest
- Dr. Peter Centre, 1110 Comox Street, Vancouver, BC, V6E 1K5, Canada
| | | | | | - Bryce Koch
- Dr. Peter Centre, 1110 Comox Street, Vancouver, BC, V6E 1K5, Canada
| | - Cheryl McDermid
- Dr. Peter Centre, 1110 Comox Street, Vancouver, BC, V6E 1K5, Canada
- Providence Health Care, Providence Crosstown Clinic, 77 East Hastings Street, Vancouver, BC, V6B 1G6, Canada
| | - Damon Hassan
- Dr. Peter Centre, 1110 Comox Street, Vancouver, BC, V6E 1K5, Canada
| | - Scott Harrison
- Providence Health Care, Providence Crosstown Clinic, 77 East Hastings Street, Vancouver, BC, V6B 1G6, Canada
| | - Eugenia Oviedo-Joekes
- Centre for Advancing Health Outcomes, Providence Health Care, St. Paul's Hospital, 575- 1081 Burrard St., Vancouver, BC, V6Z 1Y6, Canada.
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada.
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17
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Hwang JJ, Donnelly TT, Raffin Bouchal S, Davidson S. Factors influencing access to nonpharmacological interventions for community-dwelling seniors with mild-to-moderate dementia: An integrative review. J Psychiatr Ment Health Nurs 2023; 30:1054-1081. [PMID: 37203563 DOI: 10.1111/jpm.12932] [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: 09/28/2022] [Revised: 03/06/2023] [Accepted: 04/23/2023] [Indexed: 05/20/2023]
Abstract
WHAT IS KNOWN ON THE SUBJECT Research has shown effectiveness of nonpharmacological interventions in improving or maintaining cognition, mood, functioning, self-efficacy and quality of life for persons with mild-to-moderate dementia (PWDs). These interventions are critical during the earlier stages of dementia. However, Canadian and international literature report underutilization of and difficulty accessing the interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE To our knowledge, this is the first review that explored factors influencing seniors' utilization of nonpharmacological interventions in the earlier stages of dementia. This review contributed to the discovery of unique factors such as PWDs' beliefs, fears, perceptions, and acceptability of nonpharmacological interventions and environmental influences on intervention provision. PWDs' intervention uptake may appear as a matter of personal choices related to individuals' knowledge, beliefs and perceptions. However, the analysis of the research evidence suggests that PWDs' choices are shaped by environmental factors such as formal and informal caregiver support, acceptability and accessibility of nonpharmacological interventions, dementia care workforce, community's attitudes towards dementia and funding. The complex interplay among factors highlights the importance of targeting health promotion strategies at both individuals and their environments. WHAT ARE THE IMPLICATIONS FOR PRACTICE The review findings feature opportunities for healthcare practitioners, including mental health nurses, in advocating for PWDs' evidence-informed decision-making and access to desired nonpharmacological treatments. Involvement of patients and families in care-planning through ongoing assessment of health and learning needs, as well as enablers and barriers to using interventions, continuing information provision, and personalized referrals to appropriate services can promote PWDs' rights to healthcare. ABSTRACT INTRODUCTION: Despite the significance of nonpharmacological interventions in optimal management of mild-to-moderate dementia, it remains unclear in the literature how persons with mild-to-moderate dementia (PWDs) view, understand and access nonpharmacological interventions. AIM The purpose of this review was to explore the extent and nature of evidence concerning factors that influence the use of nonpharmacological interventions for community-dwelling seniors with mild-to-moderate dementia. METHOD An integrative review was undertaken following Toronto and Remington (A step-by-step guide to conducting an integrative review, 2020)'s instruction which expanded Torraco (Human Resource Development Review, 2016, 15, 404)'s and Whittemore and Knafl (Journal of Advanced Nursing, 2005, 52, 546)'s guidance. RESULTS The review of 16 studies suggests that PWDs' use of nonpharmacological interventions is shaped by a complex interplay of various personal, interpersonal, organizational, community and political influences. DISCUSSION The findings highlight the complex, interrelated relationships among multiple factors and subsequent limitations of behaviour-oriented health promotion strategies. To assist PWDs in making healthier choices, health promotion strategies need to direct attention to both individuals' behaviours and environmental conditions impacting the behaviours. IMPLICATIONS FOR PRACTICE The findings of this review can inform multidisciplinary health practitioners' (including mental health nurses) practice with seniors living with mild-to-moderate dementia. We recommend actionable ways in which they can empower patients and their families in dementia management.
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Affiliation(s)
| | | | | | - Sandra Davidson
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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18
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Dumedah G, Iddrisu S, Asare C, Adu-Prah S, English S. Inequities in spatial access to health services in Ghanaian cities. Health Policy Plan 2023; 38:1166-1180. [PMID: 37728231 DOI: 10.1093/heapol/czad084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 08/12/2023] [Accepted: 09/15/2023] [Indexed: 09/21/2023] Open
Abstract
Consideration of health equity is fundamental to enhancing the health of those who are economically/socially disadvantaged. A vital characteristic of health equity and therefore health disparity is the level of spatial access to health services and its distribution among populations. Adequate knowledge of health disparity is critical to enhancing the optimal allocation of resources, identification of underserved populations and improving the efficiency and performance of the health system. The provision of such insight for sub-Saharan African (SSA) cities is a challenge and is severely limited in the literature. Accordingly, this study examined the disparities in potential spatial access to health services for four selected urban areas in Ghana based on: (1) the number of physicians per population; (2) access score based on a weighted sum of access components; (3) travel time to health services and (4) the combined evaluation of linkages between travel distance, settlement area, population and economic status. The overall spatial access to health services is low across all selected cities varying between 3.02 and 1.78 physicians per 10 000 persons, whereas the access score is between 1.70 and 2.54. The current number of physicians needs to be increased by about five times to satisfy the World Health Organization's standard. The low spatial access is not equitable across and within the selected cities, where the economically disadvantaged populations were found to endure longer travel distances to access health services. Inequities were found to be embedded within the selected cities where economically poor populations are also disadvantaged in their physical access to healthcare. The health facilities in all cities have reasonable travel distances separating them but are inadequately resourced with physicians. Thus, increasing the physician numbers and related resources at spatially targeted existing facilities would considerably enhance spatial access to health services.
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Affiliation(s)
- Gift Dumedah
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ashanti Region 0000, Ghana
| | - Seidu Iddrisu
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ashanti Region 0000, Ghana
| | - Christabel Asare
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Private Mail Bag, University Post Office, Kumasi, Ashanti Region 0000, Ghana
| | - Samuel Adu-Prah
- Department of Environmental and Geosciences, Sam Houston State University, Huntsville, TX 77341, USA
| | - Sinead English
- School of Biological Sciences, University of Bristol, Bristol BS8 1QU, UK
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19
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Hope Ø, Ness O, Friesinger JG, Topor A, Bøe TD. 'Living needs a landscape': A qualitative study about the role of enabling landscapes for people with mental health and substance abuse problems. Health Place 2023; 84:103144. [PMID: 37976916 DOI: 10.1016/j.healthplace.2023.103144] [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: 06/23/2023] [Revised: 11/06/2023] [Accepted: 11/06/2023] [Indexed: 11/19/2023]
Abstract
The deinstitutionalization of mental health institutions has enabled service users to live in the community and search for what Duff coins 'enabling places.' These places were explored through walking interviews, in which service-users led the way. This analysis revealed features which made places promote liveable lives: places help people explore, places help people stand out, places give people responsibilities, and places dare people. An adverse feature was also identified: places define people by their problems. Overall, we suggest that 'living needs a landscape' to capture how a diversity of places form an 'enabling landscape'. This suggests a shift of focus in research and treatment, from internal to external landscapes.
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Affiliation(s)
- Øyvind Hope
- University of Agder, Department of Psychosocial Health, Grimstad, Norway.
| | - Ottar Ness
- University of Agder, Department of Psychosocial Health, Grimstad, Norway; NTNU, Nordic Research Center for Wellbeing and Social Sustainability, Trondheim, Norway
| | | | - Alain Topor
- University of Agder, Department of Psychosocial Health, Grimstad, Norway; Stockholm University, Department of Social Work, Stockholm, Sweden
| | - Tore Dag Bøe
- University of Agder, Department of Psychosocial Health, Grimstad, Norway
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20
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Gao X, Berkowitz RL, Michaels EK, Mujahid MS. Traveling Together: A Road Map for Researching Neighborhood Effects on Population Health and Health Inequities. Am J Epidemiol 2023; 192:1731-1742. [PMID: 37246316 DOI: 10.1093/aje/kwad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/12/2023] [Accepted: 05/24/2023] [Indexed: 05/30/2023] Open
Abstract
As evidence of the relationship between place and health mounts, more epidemiologists and clinical science researchers are becoming interested in incorporating place-based measures and analyses into their examination of population health and health inequities. Given the extensive literature on place and health, it can be challenging for researchers new to this area to develop neighborhood-effects research questions and apply the appropriate measures and methods. This paper provides a road map for guiding health researchers through the conceptual and methodological stages of incorporating various dimensions of place into their quantitative health research. Synthesizing across reviews, commentaries, and empirical investigations, the road map consists of 4 broad stages for considering place and health: 1) why?: articulating the motivation for assessing place and health and grounding the motivation in theory; 2) what?: identifying the relevant place-based characteristics and specifying their link to health to build a conceptual framework; 3) how?: determining how to operationalize the conceptual framework by defining, measuring, and assessing place-based characteristics and quantifying their effect on health; and 4) now what?: discussing the implications of neighborhood research findings for future research, policy, and practice. This road map supports efforts to develop conceptually and analytically rigorous neighborhood research projects.
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21
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Nunbogu AM, Elliott SJ. COVID-19 brought the water struggles in Ghana into our homes in Canada: Collective emotions and WASH struggles in distant locations during health emergencies. Health Place 2023; 83:103099. [PMID: 37634303 DOI: 10.1016/j.healthplace.2023.103099] [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: 01/10/2023] [Revised: 07/07/2023] [Accepted: 08/08/2023] [Indexed: 08/29/2023]
Abstract
The COVID-19 pandemic has heightened and made visible the embodied consequences of water, sanitation and hygiene (WASH) inequalities and the relationalities of health in place. This paper combines insights from relational geographies and embodied epidemiology to explore psychosocial concerns among Ghanaian migrants in Canada due to their multiple and simultaneous roles in the WASH space in Ghana, particularly during the COVID-19 pandemic. We explored this using narratives from in-depth interviews with 27 participants (16 women and 11 men) residing in Ontario, Canada. The case of Ghana offers insight into how social ties with home communities could provide a safety net during emergencies but could also affect the psychosocial wellbeing of migrants. Results revealed four interrelated psychosocial stressors, including social stressors, financial stressors, stressors related to perceived inequality and stressors related to the fear of infection during WASH access. The paper underscores the urgent need for research to move beyond local health implications of WASH inequalities and begin to prioritize how these social inequalities are embodied at distant locations.
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Affiliation(s)
- Abraham Marshall Nunbogu
- Department of Geography and Environmental Management, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
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22
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Gizamba JM, Wilson JP, Mendenhall E, Ferguson L. A review of place-related contextual factors in syndemics research. Health Place 2023; 83:103084. [PMID: 37437495 DOI: 10.1016/j.healthplace.2023.103084] [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: 05/15/2023] [Revised: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 07/14/2023]
Abstract
This review investigates the extent to which a place-based approach has been used to conceptualize context, as well as the place-related contextual factors explored in studies that explicitly invoked a syndemic framework. The literature search focused on 29 peer-reviewed empirical syndemic studies. Only 11 studies used a place-based approach to define and measure contextual factors and the spatial context was denoted using administrative boundaries such as census tracts, counties, and countries. A narrow range of place-related contextual factors were explored and most of them were related to social and economic factors that were used to define a place. Methodological gaps like a paucity of multilevel studies and studies using a place-based approach to measure context were identified. Future syndemics research should leverage multidimensional geospatial approaches to decipher the role of place-related contextual factors in syndemic dynamics.
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Affiliation(s)
| | - John P Wilson
- Spatial Science Institute, University of Southern California, Los Angeles, USA
| | - Emily Mendenhall
- School of Foreign Service, Georgetown University, Washington, DC, USA
| | - Laura Ferguson
- Institute on Inequalities in Global Health, Keck School of Medicine, University of Southern California, Los Angeles, USA
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23
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Oluyomi AO, Schneider SC, Christian C, Alvarez JM, Smárason O, Goodman WK, Storch EA. Geospatial Distribution of Obsessive-Compulsive Disorder Specialists: Understanding Access as a Function of Distance, Insurance Status, and Neighborhood Socioeconomic Status. J Obsessive Compuls Relat Disord 2023; 38:100829. [PMID: 37614722 PMCID: PMC10443932 DOI: 10.1016/j.jocrd.2023.100829] [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: 08/25/2023]
Abstract
Obsessive-compulsive disorder is an impairing psychiatric condition affecting 1-2% of adults and youth. Cognitive-behavioral therapy with exposure and response prevention (CBT) is an efficacious intervention but requires specialty training and access is often limited. While certain factors are associated with treatment access, one key barrier that has not been explored is the geographic availability of OCD treatment providers. Using integrated geographically-referenced data, we examined the geographic distribution of OCD CBT specialty providers across the state of Texas, with particular attention to the relationship to neighborhood socioeconomic disadvantage, insurance status, and rural versus urban status. We found that specialist providers are almost exclusively located inside the highly urbanized parts of the state, primarily in more affluent areas, and often only accept self-pay. The characteristics of the areas located the furthest away from specialty OCD care include a high proportion of persons identifying as Hispanic; a high proportion of non-English speakers, households with income below poverty; households with no vehicles; and persons with no health insurance. Average household income decreased as distances from specialist providers increased. Broadly, findings confirm that OCD CBT specialty providers are clustered in large socially advantaged areas and that economic disadvantage remains a significant barrier to care. As inadequate or inappropriate treatment of OCD is likely to result in sustained and impairing symptoms, this is of great concern.
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Affiliation(s)
- Abiodun O Oluyomi
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
- Environmental Health Service, Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA
- Gulf Coast Center for Precision Environmental Health, Baylor College of Medicine, Houston, TX, USA
| | - Sophie C Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Catherine Christian
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Juan M Alvarez
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Orri Smárason
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Faculty of Psychology, University of Iceland, Reykjavik, Iceland
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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24
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Albers PN, Rinaldi C, Brown H, Mason KE, d'Apice K, McGill E, McQuire C, Craig P, Laverty AA, Beeson M, Campbell M, Egan M, Gibson M, Fuller M, Dillon A, Taylor-Robinson D, Jago R, Tilling K, Barr B, Sniehotta FF, Hickman M, Millett CJ, de Vocht F. Natural experiments for the evaluation of place-based public health interventions: a methodology scoping review. Front Public Health 2023; 11:1192055. [PMID: 37427271 PMCID: PMC10323422 DOI: 10.3389/fpubh.2023.1192055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Introduction Place-based public health evaluations are increasingly making use of natural experiments. This scoping review aimed to provide an overview of the design and use of natural experiment evaluations (NEEs), and an assessment of the plausibility of the as-if randomization assumption. Methods A systematic search of three bibliographic databases (Pubmed, Web of Science and Ovid-Medline) was conducted in January 2020 to capture publications that reported a natural experiment of a place-based public health intervention or outcome. For each, study design elements were extracted. An additional evaluation of as-if randomization was conducted by 12 of this paper's authors who evaluated the same set of 20 randomly selected studies and assessed 'as-if ' randomization for each. Results 366 NEE studies of place-based public health interventions were identified. The most commonly used NEE approach was a Difference-in-Differences study design (25%), followed by before-after studies (23%) and regression analysis studies. 42% of NEEs had likely or probable as-if randomization of exposure (the intervention), while for 25% this was implausible. An inter-rater agreement exercise indicated poor reliability of as-if randomization assignment. Only about half of NEEs reported some form of sensitivity or falsification analysis to support inferences. Conclusion NEEs are conducted using many different designs and statistical methods and encompass various definitions of a natural experiment, while it is questionable whether all evaluations reported as natural experiments should be considered as such. The likelihood of as-if randomization should be specifically reported, and primary analyses should be supported by sensitivity analyses and/or falsification tests. Transparent reporting of NEE designs and evaluation methods will contribute to the optimum use of place-based NEEs.
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Affiliation(s)
- Patricia N. Albers
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Chiara Rinaldi
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Heather Brown
- Health Research, Lancaster University, Lancaster, United Kingdom
| | - Kate E. Mason
- Department of Public Health Policy and Systems, University of Liverpool, Liverpool, United Kingdom
- Centre for Health Policy, University of Melbourne, Parkville, VIC, Australia
| | - Katrina d'Apice
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Elizabeth McGill
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Cheryl McQuire
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Peter Craig
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Anthony A. Laverty
- School of Public Health, Imperial College London, London, United Kingdom
| | - Morgan Beeson
- Newcastle University Business School, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Mhairi Campbell
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Matt Egan
- Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Marcia Gibson
- MRC/CSO Social and Public Health Sciences Unit, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Maxwell Fuller
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Amy Dillon
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - David Taylor-Robinson
- Department of Public Health, Policy and Systems. University of Liverpool, Liverpool, United Kingdom
| | - Russell Jago
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, United Kingdom
| | - Kate Tilling
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Benjamin Barr
- Institute of Population Health, University of Liverpool, Liverpool, United Kingdom
| | - Falko F. Sniehotta
- NIHR Policy Research Unit Behavioural Science, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | | | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- The National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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25
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Wang Y, Steenbergen B, van der Krabben E, Kooij HJ, Raaphorst K, Hoekman R. The Impact of the Built Environment and Social Environment on Physical Activity: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6189. [PMID: 37372774 DOI: 10.3390/ijerph20126189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 06/02/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023]
Abstract
This scoping review aims to provide an overview of the current state of physical activity research, focusing on the interplay between built and social environments and their respective influences on physical activity. We comprehensively searched electronic databases to identify relevant studies published between 2000 and 2022. A total of 35 articles have been reviewed based on the research question. The review found that built and social environments influence physical activity, and consideration of people's perceptions of their surroundings can provide further insight. The literature was summarized, and recommendations were made for future research. Findings suggest that interventions targeting built and social environments can promote physical activity effectively. However, limitations in the literature exist, including a need for more standardization in research methods and consistency in measurement tools.
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Affiliation(s)
- Yiyu Wang
- Behavioral Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Bert Steenbergen
- Behavioral Science Institute, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Erwin van der Krabben
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Henk-Jan Kooij
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
| | - Kevin Raaphorst
- Department of Geography, Planning, and Environment, Institute for Management Research, Radboud University, 6525 XZ Nijmegen, The Netherlands
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26
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Oh DL, Kemper KE, Meltzer D, Canchola AJ, Bibbins-Domingo K, Lyles CR. Neighborhood-level COVID vaccination and booster disparities: A population-level analysis across California. SSM Popul Health 2023; 22:101366. [PMID: 36873265 PMCID: PMC9982676 DOI: 10.1016/j.ssmph.2023.101366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 12/02/2022] [Accepted: 02/16/2023] [Indexed: 02/24/2023] Open
Abstract
Objectives To describe vaccine and booster uptake by neighborhood-level factors in California. Methods We examined trends in COVID-19 vaccination up to September 21, 2021, and boosters up to March 29, 2022 using data from the California Department of Public Health. Quasi-Poisson regression was used to model the association between neighborhood-level factors and fully vaccinated and boosted among ZIP codes. Sub-analyses on booster rates were compared among the 10 census regions. Results In a minimally adjusted model, a higher proportion of Black residents was associated with lower vaccination (HR = 0.97; 95%CI: 0.96-0.98). However, in a fully adjusted model, proportion of Black, Hispanic/Latinx, and Asian residents were associated with higher vaccination rates (HR = 1.02; 95%CI: 1.01-1.03 for all). The strongest predictor of low vaccine coverage was disability (HR = 0.89; 95%CI: 0.86-0.91). Similar trends persisted for booster doses. Factors associated with booster coverage varied by region. Conclusions Examining neighborhood-level factors associated with COVID-19 vaccination and booster rates uncovered significant variation within the large and geographically and demographically diverse state of California. Equity-based approaches to vaccination must ensure a robust consideration of multiple social determinants of health.
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Affiliation(s)
- Debora L Oh
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States
| | - Kathryn E Kemper
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States.,UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94143, United States
| | - Dan Meltzer
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States
| | - Alison J Canchola
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States
| | - Kirsten Bibbins-Domingo
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States.,UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94143, United States.,Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Portrero Avenue, Bldg 10, San Francisco, CA, 94110, United States
| | - Courtney R Lyles
- Department of Epidemiology & Biostatistics, University of California San Francisco, 550 16th Street, 2nd Floor, San Francisco, CA, 94158, United States.,UCSF Center for Vulnerable Populations, Zuckerberg San Francisco General Hospital, 2789 25th Street, Suite 350, San Francisco, CA, 94143, United States.,Department of Medicine, Division of General Internal Medicine at Zuckerberg San Francisco General Hospital, University of California San Francisco, 1001 Portrero Avenue, Bldg 10, San Francisco, CA, 94110, United States
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27
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Cho A, Mendenhall E, Griffith DM. Power, place, and access: Why history is at the center of black D.C. residents of wards 7 and 8 decisions to receive the COVID-19 vaccine. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 3:100270. [PMID: 37073370 PMCID: PMC10101486 DOI: 10.1016/j.ssmqr.2023.100270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 02/26/2023] [Accepted: 04/08/2023] [Indexed: 04/20/2023]
Abstract
Vaccines have played an essential role in curbing case and mortality rates due to SARS-CoV-2 in the United Sates. Still, many communities display high rates of unwillingness or inability to get a COVID-19 vaccine, limiting overall vaccination efforts and contributing to viral spread. Black Americans have expressed skepticism towards vaccines because of limited access to the technology, mistrust in its safety and efficacy, and a lack of confidence in the healthcare authorities that distribute it. This article investigates how Black residents of Wards 7 and 8 in Washington, D.C. thought about COVID-19 vaccination and why or why not they decided to vaccinate. These Wards' vaccination rates were markedly lower than those from Wards 1-6, which have substantially higher populations of White residents, affluence, access, and resources. This study involved 31 interviews with Ward 7 and 8 residents recruited through snowball sampling. We found that residents navigated the dual perceived risks of coronavirus infection and vaccination through three key frames: their relationship to their place or location, their desires to maintain autonomy over their health, and their abilities to access COVID-19 vaccines. This case study advances knowledge of vaccine utilization among marginalized communities, and how this phenomenon varies depending on local social, cultural, and political dynamics. Moreover, this research has implications for vaccine rollout efforts and the D.C. health system, as it reveals gaps in confidence and care that undermine health outcomes for Black residents.
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Affiliation(s)
- Allison Cho
- Edmund A Walsh School of Foreign Service, Georgetown University, 3700 O St. NW, Washington, DC, 20057, USA
| | - Emily Mendenhall
- Edmund A Walsh School of Foreign Service, Georgetown University, 3700 O St. NW, Washington, DC, 20057, USA
| | - Derek M Griffith
- Racial Justice Institute and School of Health, Georgetown University, 3700 O St. NW, Washington, DC, 20057, USA
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28
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Malatzky CAR, Couch DL. The Power in Rural Place Stigma. JOURNAL OF BIOETHICAL INQUIRY 2023; 20:237-248. [PMID: 37160522 PMCID: PMC10352411 DOI: 10.1007/s11673-023-10260-9] [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] [Received: 08/16/2022] [Accepted: 10/27/2022] [Indexed: 05/11/2023]
Abstract
The phenomenon and implications of stigma have been recognized across many contexts and in relation to many discrete issues or conditions. The notion of spatial stigma has been developed within stigma literature, although the importance and relevance of spatial stigma for rural places and rural people have been largely neglected. This is the case even within fields of inquiry like public and rural health, which are expansively tasked with addressing the socio-structural drivers of health inequalities. In this paper, we argue that developing a better understanding of rural place stigma is critical for addressing contemporary patterns of spatial injustice and health inequalities affecting rural communities globally. Drawing on international literature and examples from the reported experiences of rurally living Australians and news and other media, we present an analysis highlighting the power in rural place stigma. In doing so, we build a case for the relevance and importance of interrogating rural place stigma, especially in the fields of public and rural health, for changing the conditions within-and the broader positioning of-the rural in the public and political landscapes.
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Affiliation(s)
- Christina A. R. Malatzky
- Centre for Justice, School of Public Health and Social Work, Queensland University of Technology, 149 Victoria Park Road, Kelvin Grove, Queensland 4059 Australia
| | - Danielle L. Couch
- Monash Rural Health, Monash University, PO Box 666, Bendigo, Victoria 3552 Australia
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29
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Arnold BF, Rerolle F, Tedijanto C, Njenga SM, Rahman M, Ercumen A, Mertens A, Pickering A, Lin A, Arnold CD, Das K, Stewart CP, Null C, Luby SP, Colford JM, Hubbard AE, Benjamin-Chung J. Geographic pair-matching in large-scale cluster randomized trials. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.30.23289317. [PMID: 37205361 PMCID: PMC10187339 DOI: 10.1101/2023.04.30.23289317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Custer randomized trials are often used to study large-scale public health interventions. In large trials, even small improvements in statistical efficiency can have profound impacts on the required sample size and cost. Pair matched randomization is one strategy with potential to increase trial efficiency, but to our knowledge there have been no empirical evaluations of pair-matching in large-scale, epidemiologic field trials. Location integrates many socio-demographic and environmental characteristics into a single feature. Here, we show that geographic pair-matching leads to substantial gains in statistical efficiency for 14 child health outcomes that span growth, development, and infectious disease through a re-analysis of two large-scale trials of nutritional and environmental interventions in Bangladesh and Kenya. We estimate relative efficiencies ≥1.1 for all outcomes assessed and relative efficiencies regularly exceed 2.0, meaning an unmatched trial would have needed to enroll at least twice as many clusters to achieve the same level of precision as the geographically pair-matched design. We also show that geographically pair-matched designs enable estimation of fine-scale, spatially varying effect heterogeneity under minimal assumptions. Our results demonstrate broad, substantial benefits of geographic pair-matching in large-scale, cluster randomized trials.
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Affiliation(s)
- Benjamin F. Arnold
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
- Department of Ophthalmology, University of California, San Francisco, CA, USA
| | - Francois Rerolle
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Christine Tedijanto
- Francis I. Proctor Foundation, University of California, San Francisco, CA, USA
| | - Sammy M. Njenga
- Eastern and Southern Africa Centre of International Parasite Control, Kenya Medical Research Institute, Nairobi, Kenya
| | - Mahbubur Rahman
- Environmental Interventions Unit, Infectious Diseases Division, icddr,b, Dhaka, Bangladesh
| | - Ayse Ercumen
- Department of Forestry and Environmental Resources, North Carolina State University, Raleigh, NC, USA
| | - Andrew Mertens
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Amy Pickering
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
- Chan Zuckerberg Biohub, San Francisco, CA
| | - Audrie Lin
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | | | - Kishor Das
- School of Mathematical and Statistical Sciences, University of Galway, Galway, Ireland
| | | | | | - Stephen P. Luby
- Infectious diseases and Geographic Medicine, Stanford University, Stanford, California
| | - John M. Colford
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA, USA
| | - Alan E. Hubbard
- Division of Biostatistics, School of Public Health, University of California, Berkeley, CA, USA
| | - Jade Benjamin-Chung
- Chan Zuckerberg Biohub, San Francisco, CA
- Department of Epidemiology and Population Health, Stanford University, CA, USA
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30
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Azhar S, Ross AM, Keller E, Weed J, Acevedo G. Predictors of Food Insecurity and Childhood Hunger in the Bronx During the COVID-19 Pandemic. CHILD & ADOLESCENT SOCIAL WORK JOURNAL : C & A 2023:1-14. [PMID: 37363071 PMCID: PMC10183692 DOI: 10.1007/s10560-023-00927-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/14/2023] [Indexed: 06/28/2023]
Abstract
Using a community-based participatory research approach, we conducted a survey of 218 food pantry recipients in the south Bronx to determine predictors of food insecurity and childhood hunger. In adjusted multiple regression models, statistically significant risk factors for food insecurity included: having one or more children and not having health insurance. Statistically significant protectors against childhood hunger were: having a graduate degree, having health insurance and Spanish being spoken at home. Experiencing depression symptoms was positively associated with both food insecurity and childhood hunger. Frequency of food pantry use was not significantly associated with either food insecurity nor childhood hunger. This study suggests that targeting families with multiple children and without insurance will best help to promote food security among residents of the south Bronx. Social policy implications related to food security and benefit provision through the COVID-19 pandemic are also provided.
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Affiliation(s)
- Sameena Azhar
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
| | - Abigail M. Ross
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
| | - Eve Keller
- Fordham University, Fordham College at Rose Hill, New York, USA
| | | | - Gregory Acevedo
- Fordham University, Graduate School of Social Service, 113 W. 60th Street, Room 716E, New York, NY 10023 USA
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31
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Rong T, Ristevski E, Carroll M. Exploring community engagement in place-based approaches in areas of poor health and disadvantage: A scoping review. Health Place 2023; 81:103026. [PMID: 37084705 DOI: 10.1016/j.healthplace.2023.103026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/18/2023] [Accepted: 04/03/2023] [Indexed: 04/23/2023]
Abstract
A scoping review was conducted to explore the characteristics, barriers, and enablers of community engagement in place-based approaches to improving health outcomes in a designated area of poor health and disadvantage. The Joanna Briggs Institute methodology for scoping reviews was used. Forty articles met the inclusion criteria of which 31 were conducted in the United Kingdom, United States, Canada, or Australia, and 70% used qualitative methods. The health initiatives were delivered in multiple settings including neighbourhoods, towns, and regions and with a range of population groups including Indigenous and migrant communities. Trust, power, and cultural considerations were the most significant barriers and enablers to community participation in place-based approaches. Developing trust is key to success in community-led, place-based initiatives.
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Affiliation(s)
- Tanya Rong
- Monash Rural Health - Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia.
| | - Eli Ristevski
- Monash Rural Health - Warragul, Monash University, 15 Sargeant Street, Warragul, Victoria, 3820, Australia.
| | - Matthew Carroll
- Monash Rural Health - Churchill, Monash University, Northways Road, Churchill, Victoria, 3842, Australia.
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32
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Rodriguez MI, Meath THA, Watson K, Daly A, Tracy K, McConnell KJ. Geographic Variation In Effective Contraceptive Use Among Medicaid Recipients In 2018. Health Aff (Millwood) 2023; 42:537-545. [PMID: 37011322 DOI: 10.1377/hlthaff.2022.00992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Medicaid is the largest payer for publicly funded contraception, serving millions of women across the United States. However, relatively little is known about the extent to which effective contraceptive services vary geographically for Medicaid recipients. This study used national Medicaid claims to assess county-level variation in rates of provision of the most or moderately effective methods of contraception and provision of long-acting reversible contraception (LARC) across forty states and Washington, D.C., in 2018. County-level rates of most or moderately effective contraceptive use varied almost fourfold across states, from a low of 10.8 percent to a high of 44.4 percent. Rates of LARC provision varied almost tenfold, from a low of 1.0 percent to a high of 9.6 percent. Despite the fact that contraception is a core benefit within Medicaid, access and use vary substantially across and within states. Medicaid agencies have a variety of options to ensure that people have access to a choice of the full range of contraceptive methods, including removing or loosening utilization controls, incorporating quality metrics or value-based payments into contraceptive services, and adjusting reimbursement to remove barriers to the clinical provision of LARC.
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Affiliation(s)
- Maria I Rodriguez
- Maria I. Rodriguez , Oregon Health & Science University, Portland, Oregon
| | | | | | - Ashley Daly
- Ashley Daly, Oregon Health & Science University
| | - Kyle Tracy
- Kyle Tracy, Oregon Health & Science University
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33
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Randall NL, Sanders CE, Lamm AJ, Berg AC. Qualitative Exploration of Cultural Influence on a Rural Health-Promotion Initiative. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:255-265. [PMID: 36670027 DOI: 10.1016/j.jneb.2022.10.011] [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: 03/29/2022] [Revised: 10/14/2022] [Accepted: 10/27/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To develop a conceptualization of cultural influence on perceptions of a rural food and physical activity policy, systems, and environmental (PSE) change project to inform public health research and practice. DESIGN Basic qualitative research design, semistructured phone interviews with community health coalition members. SETTING Five rural Southern counties (obesity prevalence > 40%). PARTICIPANTS Thirty-nine community coalition members. INTERVENTION The Centers for Disease Control and Prevention High Obesity Program. PSE initiatives to increase access to healthy food and physical activity opportunities through a community coalition model. PHENOMENON OF INTEREST Social norms and cultural influences surrounding community members' food preferences, physical activity behavior, and future hopes for community development. ANALYSIS Abductive content analysis. RESULTS Major categories on food social norms (subcategories: physical health, eating habits, and food preference), race relations, generational factors, physical activity social norms, and hopes for the community (subcategories: increased engagement, health, awareness, cohesion, and inspiration) were discussed in relation to the progress of PSE initiatives. CONCLUSIONS AND IMPLICATIONS Because of community member perceptions, PSE initiatives became associated with factors beyond food and fitness, such as race relations, generational differences, and community cohesion. A focus on increased youth and church involvement, community values, relationship building, and input from diverse voices can be foundational to culturally-appropriate PSE efforts in rural settings.
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Affiliation(s)
- Nekeisha L Randall
- Department of Lifelong Education, Administration, and Policy, Mary Frances Early College of Education, University of Georgia, Athens, GA; Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA
| | - Catherine E Sanders
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA.
| | - Alexa J Lamm
- Department of Agricultural Leadership, Education, and Communication, College of Agricultural and Environmental Sciences, University of Georgia, Athens, GA
| | - Alison C Berg
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA
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34
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Couper I, Jaques K, Reid A, Harris P. Placemaking and infrastructure through the lens of levelling up for health equity: A scoping review. Health Place 2023; 80:102975. [PMID: 36774810 DOI: 10.1016/j.healthplace.2023.102975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/12/2023] [Accepted: 01/24/2023] [Indexed: 02/12/2023]
Abstract
The planning and delivery of infrastructure influences how places create health equity. The scholarship on place and health has recently been developed into 'levelling up' principles for equity focussed policy and planning. We conducted a scoping review of the literature on infrastructure through urban regeneration and placemaking interventions. We interrogated the 15 final selected articles for their use of one or more of the five 'levelling' up principles. No article encompassed all five principles. It was most common to find two or three principles in action. Reviewing the articles against the principles allows a deeper explanation of how infrastructure planning practice can positively impact on health equity. We conclude that applying all the principles in standard infrastructure planning practice has great potential for creating places that are positive for health equity.
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Affiliation(s)
- Ines Couper
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Karla Jaques
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Andrew Reid
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia
| | - Patrick Harris
- Centre for Health Equity, Training, Research & Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care & Equity, A Unit of Population Health, South Western Sydney Local Health District, NSW Health, Ingham Institute, Liverpool Hospital Locked Bag 7103, Liverpool, BC NSW, 1871, Australia.
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35
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Montoya-Sanabria SM. Rurality as an analytic category: implications for public health. Rev Salud Publica (Bogota) 2023; 22:642-648. [PMID: 36753083 DOI: 10.15446/rsap.v22n6.91280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 11/30/2020] [Indexed: 11/09/2022] Open
Abstract
Rurality as a concept was originated within the framework of the migration phenomena of the nineteenth century. During the post-war period, a dichotomic approach was established for this concept, along with the emerging notion of growth, which influenced the economic models of multiple countries worldwide. However, during the last 50 years, the rurality concept acquired a polysemic nature. Thus, the main objective of this article is analyzing several definitions of rurality from the perspective of some subdisciplines of the social sciences and their lines of thought to evaluate their implications for public health within different contexts.
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Affiliation(s)
- Sandra Milena Montoya-Sanabria
- SM: RN. M. Sc. Salud Pública. Ph.D. (c) Salud Pública. Universidad Nacional de Colombia. Profesora e investigadora. Instituto de Salud Pública, Pontificia Universidad Javeriana. Bogotá, Colombia.
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36
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Augustin J, Andrees V, Walsh D, Reintjes R, Koller D. Spatial Aspects of Health-Developing a Conceptual Framework. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1817. [PMID: 36767185 PMCID: PMC9914219 DOI: 10.3390/ijerph20031817] [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: 11/29/2022] [Revised: 01/16/2023] [Accepted: 01/16/2023] [Indexed: 06/18/2023]
Abstract
Numerous studies and models address the determinants of health. However, in existing models, the spatial aspects of the determinants are not or only marginally taken into account and a theoretical discussion of the association between space and the determinants of health is missing. The aim of this paper is to generate a framework that can be used to place the determinants of health in a spatial context. A screening of the current first serves to identify the relevant determinants and describes the current state of knowledge. In addition, spatial scales that are important for the spatial consideration of health were developed and discussed. Based on these two steps, the conceptual framework on the spatial determinants of health was derived and subsequently discussed. The results show a variety of determinants that are associated with health from a spatial point of view. The overarching categories are global driving forces, policy and governance, living and physical environment, socio-demographic and economic conditions, healthcare services and cultural and working conditions. Three spatial scales (macro, meso and micro) are further subdivided into six levels, such as global (e.g., continents), regional (e.g., council areas) or neighbourhood (e.g., communities). The combination of the determinants and spatial scales are presented within a conceptual framework as a result of this work. Operating mechanisms and pathways between the spatial levels were added schematically. This is the first conceptual framework that links the determinants of health with the spatial perspective. It can form the working basis for future analyses in which spatial aspects of health are taken into account.
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Affiliation(s)
- Jobst Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - Valerie Andrees
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - David Walsh
- Glasgow Centre for Population Health, Glasgow G40 2QH, UK
| | - Ralf Reintjes
- Department of Health Sciences, Faculty of Life Sciences, Hamburg University of Applied Sciences, 20999 Hamburg, Germany
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33100 Tampere, Finland
| | - Daniela Koller
- IBE—Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians-Universität München, 81377 Munich, Germany
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Wood GER, Pykett J, Banchoff A, King AC, Stathi A. Employing citizen science to enhance active and healthy ageing in urban environments. Health Place 2023; 79:102954. [PMID: 36493495 DOI: 10.1016/j.healthplace.2022.102954] [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: 06/23/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
Engaging older residents in problem definition and solution-building is key to the success of place-based initiatives endeavouring to increase the age-friendliness of urban environments. This study employed the Our Voice framework, engaging older adult citizen scientists (n = 14) and community stakeholders (n = 15) across the city of Birmingham, UK. With the aim of identifying urban features impacting age friendliness and co-producing recommendations for improving local urban areas, citizen scientists participated in 12 technology-enabled walkability assessments, three in-person discussion groups, two one-to-one online discussions, and two workshops with community stakeholders. Together, citizen scientists co-produced 12 local and six city-wide recommendations. These recommendations were embedded into an implementation framework based on workshop discussions to identify age-friendly pathways in urban environments.
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Affiliation(s)
- G E R Wood
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK.
| | - J Pykett
- School of Geography, Earth and Environmental Sciences, University of Birmingham, UK
| | - A Banchoff
- Department of Epidemiology & Population Health, Stanford University School of Medicine, USA
| | - A C King
- Department of Epidemiology & Population Health, Stanford University School of Medicine, USA; Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, USA
| | - A Stathi
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, UK
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Nunbogu AM, Elliott SJ, Bisung E. I feel the pains of our past water struggles anytime I turn on the tap: Diaspora perceptions and experiences of water, sanitation, and hygiene (WaSH) gendered violence in Ghana. Soc Sci Med 2023; 317:115621. [PMID: 36542928 DOI: 10.1016/j.socscimed.2022.115621] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 12/09/2022] [Accepted: 12/13/2022] [Indexed: 12/16/2022]
Abstract
Gender-based violence resulting from water, sanitation and hygiene (WASH) insecurity is a major public health problem. WaSH gender-based (WaSH-GBV) is a spatio-temporal experience and has disproportionate health and wellbeing impacts on women and girls. However, the global community of WaSH practitioners and policymakers is yet to adequately address women's vulnerability to violence in relation to WaSH access. Informed by the feminist political ecology of health framework, we conducted in-depth interviews (n = 27, 16 women and 11 men) with Ghanaian immigrants to Canada to explore perceptions of WaSH experiences over lifecourse. Results revealed that participants' perceptions and experiences of GBV are both socially and context dependent, organized around four dimensions: structural, physical, psychological, and sexual. These muti-scalar dimensions of diasporans' WaSH experiences and perceptions in Ghana are discussed along with their implications for policy and practice, specifically in enhancing health equity and water security.
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Affiliation(s)
- Abraham Marshall Nunbogu
- Department of Geography and Environmental Management, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
| | - Susan J Elliott
- Department of Geography and Environmental Management, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | - Elijah Bisung
- School of Kinesiology and Health Studies, Queen's University Kingston, ON, Canada
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39
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Schnake-Mahl AS, Jahn JL, Purtle J, Bilal U. Considering multiple governance levels in epidemiologic analysis of public policies. Soc Sci Med 2022; 314:115444. [PMID: 36274459 PMCID: PMC9896379 DOI: 10.1016/j.socscimed.2022.115444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 10/04/2022] [Accepted: 10/08/2022] [Indexed: 11/06/2022]
Abstract
Epidemiology is increasingly asking questions about the use of policies to address structural inequities and intervene on health disparities and public health challenges. However, there has been limited explicit consideration of governance structures in the design of epidemiologic policy analysis. To advance empirical and theoretical inquiry in this space, we propose a model of governance analysis in which public health researchers consider at what level 1) decision-making authority for policy sits, 2) policy is implemented, 3) and accountability for policy effects appear. We follow with examples of how these considerations might improve the evaluation of the policy drivers of population health. Consideration and integration of multiple levels of governance, as well as interactions between levels, can help epidemiologists design studies including new opportunities for quasi-experimental designs and stronger counterfactuals, better quantify the policy drivers of inequities, and aid research evidence and policy development work in targeting multiple levels of governance, ultimately supporting evidence-based policy making.
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Affiliation(s)
- Alina S Schnake-Mahl
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA.
| | - Jaquelyn L Jahn
- The Ubuntu Center on Racism, Global Movements & Population Health Equity, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, Global Center for Implementation Science, New York University School of Global Public Health, New York University, New York, NY, USA
| | - Usama Bilal
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
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40
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Castellani B, Bartington S, Wistow J, Heckels N, Ellison A, Van Tongeren M, Arnold SR, Barbrook-Johnson P, Bicket M, Pope FD, Russ TC, Clarke CL, Pirani M, Schwannauer M, Vieno M, Turnbull R, Gilbert N, Reis S. Mitigating the impact of air pollution on dementia and brain health: Setting the policy agenda. ENVIRONMENTAL RESEARCH 2022; 215:114362. [PMID: 36130664 DOI: 10.1016/j.envres.2022.114362] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 09/13/2022] [Accepted: 09/14/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Emerging research suggests exposure to high levels of air pollution at critical points in the life-course is detrimental to brain health, including cognitive decline and dementia. Social determinants play a significant role, including socio-economic deprivation, environmental factors and heightened health and social inequalities. Policies have been proposed more generally, but their benefits for brain health have yet to be fully explored. OBJECTIVE AND METHODS Over the course of two years, we worked as a consortium of 20+ academics in a participatory and consensus method to develop the first policy agenda for mitigating air pollution's impact on brain health and dementia, including an umbrella review and engaging 11 stakeholder organisations. RESULTS We identified three policy domains and 14 priority areas. Research and Funding included: (1) embracing a complexities of place approach that (2) highlights vulnerable populations; (3) details the impact of ambient PM2.5 on brain health, including current and historical high-resolution exposure models; (4) emphasises the importance of indoor air pollution; (5) catalogues the multiple pathways to disease for brain health and dementia, including those most at risk; (6) embraces a life course perspective; and (7) radically rethinks funding. Education and Awareness included: (8) making this unrecognised public health issue known; (9) developing educational products; (10) attaching air pollution and brain health to existing strategies and campaigns; and (11) providing publicly available monitoring, assessment and screening tools. Policy Evaluation included: (12) conducting complex systems evaluation; (13) engaging in co-production; and (14) evaluating air quality policies for their brain health benefits. CONCLUSION Given the pressing issues of brain health, dementia and air pollution, setting a policy agenda is crucial. Policy needs to be matched by scientific evidence and appropriate guidelines, including bespoke strategies to optimise impact and mitigate unintended consequences. The agenda provided here is the first step toward such a plan.
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Affiliation(s)
- Brian Castellani
- Durham Research Methods Centre, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom; Centre for the Evaluation of Complexity Across the Nexus, University of Surrey, Guildford, GU2 7XH, United Kingdom; Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton Road, DH1 3LE, United Kingdom; Department of Sociology, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom.
| | - Suzanne Bartington
- Institute of Applied Health Research, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Jonathan Wistow
- Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton Road, DH1 3LE, United Kingdom; Department of Sociology, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom
| | - Neil Heckels
- Research and Innovation Services, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom
| | - Amanda Ellison
- Wolfson Research Institute for Health and Wellbeing, Durham University, Stockton Road, DH1 3LE, United Kingdom; Department of Psychology, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom
| | - Martie Van Tongeren
- Centre for Occupational and Environmental Health, School of Health Sciences, University of Manchester, Manchester, M13 9PL, United Kingdom
| | - Steve R Arnold
- School of Earth & Environment, University of Leeds, Leeds, LS2 9JT, United Kingdom
| | - Pete Barbrook-Johnson
- Centre for the Evaluation of Complexity Across the Nexus, University of Surrey, Guildford, GU2 7XH, United Kingdom; Environmental Change Institute, School of Geography and the Environment, University of Oxford, United Kingdom
| | - Martha Bicket
- Centre for the Evaluation of Complexity Across the Nexus, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Francis D Pope
- School of Geography, Earth and Environmental Sciences, University of Birmingham, Birmingham, B15 2TT, United Kingdom
| | - Tom C Russ
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, United Kingdom; Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Charlotte L Clarke
- Department of Sociology, Durham University, Stockton Road, Durham, DH1 3LE, United Kingdom; School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, United Kingdom
| | - Monica Pirani
- MRC Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, Norfolk Place, W2 1PG, London, United Kingdom
| | - Matthias Schwannauer
- School of Health in Social Science, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, United Kingdom
| | - Massimo Vieno
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian, EH26 0QB, United Kingdom
| | - Rachel Turnbull
- Academic Health Sciences Network, North East and North Cumbria, Nuns' Moor Road, Newcastle Upon Tyne NE4 5PL, United Kingdom
| | - Nigel Gilbert
- Centre for the Evaluation of Complexity Across the Nexus, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Stefan Reis
- UK Centre for Ecology & Hydrology, Bush Estate, Penicuik, Midlothian, EH26 0QB, United Kingdom; University of Exeter Medical School, European Centre for Environment and Health, Knowledge Spa, Truro, TR1 3HD, United Kingdom; The University of Edinburgh, School of Chemistry, Level 3, Murchison House, 10 Max Born Crescent, The King's Buildings, West Mains Road, Edinburgh, EH9 3BF, United Kingdom
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Kim J, Kim DH, Lee J, Cheon Y, Yoo S. A scoping review of qualitative geographic information systems in studies addressing health issues. Soc Sci Med 2022; 314:115472. [PMID: 36334495 DOI: 10.1016/j.socscimed.2022.115472] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/11/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022]
Abstract
Qualitative Geographic Information Systems (QGIS) represent an emerging geospatial and qualitative approach to comprehensively understand health issues. This scoping review gathers evidence from 38 articles to illuminate when and how QGIS is used to address health issues. QGIS can contribute to recent health-related studies focusing on determinants of health and health equity at the community rather than individual level, highlight relationships between place and health, and encourage participation from people and communities in health-decision making. If more studies attempt to specify detailed data analysis methods and develop ways to use rich contexts of qualitative data, QGIS can provide greater scope for those working to solve health problems.
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Affiliation(s)
- Jisun Kim
- 1 Gwanak-ro, Gwanak-ku, Seoul National University, Department of Public Health Sciences, Graduate School of Public Health, Building 221, Seoul, 08826, Republic of Korea
| | - Dong Ha Kim
- 1 Gwanak-ro, Gwanak-ku, Seoul National University, Institute of Health and Environment, Building 220, Room 228-3, Seoul, 08826, Republic of Korea
| | - Jihyun Lee
- 1 Gwanak-ro, Gwanak-ku, Seoul National University, Department of Public Health Sciences, Graduate School of Public Health, Building 221, Seoul, 08826, Republic of Korea
| | - Youngseo Cheon
- 253 Ayeon-ro, Jeju-si, Jeju Research Institute, Jeju, 63147, Republic of Korea
| | - Seunghyun Yoo
- 1 Gwanak-ro, Gwanak-ku, Seoul National University, Department of Public Health Sciences, Graduate School of Public Health, Building 221, Seoul, 08826, Republic of Korea; 1 Gwanak-ro, Gwanak-ku, Seoul National University, Institute of Health and Environment, Building 220, Room 228-3, Seoul, 08826, Republic of Korea.
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42
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Surrenti S. Observing the Outpatient-Waiting Experience in a Day Hospital Setting: Qualitative Exploration. Hosp Top 2022:1-11. [PMID: 36346378 DOI: 10.1080/00185868.2022.2140092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The space-time design of hospital care services is still an underdeveloped topic in sociological and medical literature. The article explores the social affordances inscribed in the space-time design of a hospital outpatient waiting room in relation to people care engagement and emotional comfort. The aim is to extend considerations to the broader context of relational and person-centered care. Observations employed of participants in the field study have a two-fold focus. One is 'waiting' for a service or a person, and the other is 'expecting' something or someone from a service. 'Multisensory-scape' and 'Self-less subject' are two metaphors I have adopted to describe the in field patient waiting experience. In the first case, people's perception of hospital staff seeing and hearing them is central to observation in the care path. The second case is instead the result of people feeling a loss of identity when there is a time-mismatch between daily life routines and hospital organization rules. It is fundamental to consider the impact on people's waiting experience because citizens and patients trace their feelings of 'being taken into charge' and 'continuity of care' back to the emotional comfort experienced the first moment they accessed the space-time design of hospital services.
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Affiliation(s)
- Silvia Surrenti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
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43
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Schnake-Mahl AS, Mullachery PH, Purtle J, Li R, Diez Roux AV, Bilal U. Heterogeneity in Disparities in Life Expectancy Across US Metropolitan Areas. Epidemiology 2022; 33:890-899. [PMID: 36220582 PMCID: PMC9574908 DOI: 10.1097/ede.0000000000001537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND Life expectancy in the United States has declined since 2014 but characterization of disparities within and across metropolitan areas of the country is lacking. METHODS Using census tract-level life expectancy from the 2010 to 2015 US Small-area Life Expectancy Estimates Project, we calculate 10 measures of total and income-based disparities in life expectancy at birth, age 25, and age 65 within and across 377 metropolitan statistical areas (MSAs) of the United States. RESULTS We found wide heterogeneity in disparities in life expectancy at birth across MSAs and regions: MSAs in the West show the narrowest disparities (absolute disparity: 8.7 years, relative disparity: 1.1), while MSAs in the South (absolute disparity: 9.1 years, relative disparity: 1.1) and Midwest (absolute disparity: 9.8 years, relative disparity: 1.1) have the widest life expectancy disparities. We also observed greater variability in life expectancy across MSAs for lower income census tracts (coefficient of variation [CoV] 3.7 for first vs. tenth decile of income) than for higher income census tracts (CoV 2.3). Finally, we found that a series of MSA-level variables, including larger MSAs and greater proportion college graduates, predicted wider life expectancy disparities for all age groups. CONCLUSIONS Sociodemographic and policy factors likely help explain variation in life expectancy disparities within and across metro areas.
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Affiliation(s)
- Alina S Schnake-Mahl
- From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA
- Department of Health Management and Policy, Drexel University, Philadelphia, PA
| | - Pricila H Mullachery
- From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Jonathan Purtle
- Department of Public Health Policy & Management, New York University School of Global Public Health, New York, NY
| | - Ran Li
- From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Ana V Diez Roux
- From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | - Usama Bilal
- From the Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
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COVID-19 and deprivation amplification: An ecological study of geographical inequalities in mortality in England. Health Place 2022; 78:102933. [PMID: 36417814 PMCID: PMC9637535 DOI: 10.1016/j.healthplace.2022.102933] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 10/04/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022]
Abstract
'Deprivation amplification' is used to understand the relationship between deprivation, scale and COVID-19 mortality rates. We found that more deprived Middle Super Output Areas (MSOAs) in the more deprived northern regions suffered greater COVID-19 mortality rates. Across England, the most deprived 20% of MSOAs had higher mortality than the least deprived (44.1% more COVID-19 deaths/10,000). However, the most deprived MSOAs in the north fared worse than equally deprived areas in the rest of England (14.5% more deaths/10,000, beta = 0.136, p < 0.01). There was also strong evidence of spatial clustering and spill-overs. We discuss these findings in relation to 'deprivation amplification', the 'syndemic pandemic', and the health and place literature.
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Albani V, Welsh CE, Brown H, Matthews FE, Bambra C. Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England. Soc Sci Med 2022; 311:115319. [PMID: 36088725 PMCID: PMC9441468 DOI: 10.1016/j.socscimed.2022.115319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/31/2022] [Accepted: 08/25/2022] [Indexed: 12/02/2022]
Abstract
One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.
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Affiliation(s)
- Viviana Albani
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Claire E Welsh
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Heather Brown
- Department of Health Research, Faculty of Health and Medicine, Lancaster University, UK
| | - Fiona E Matthews
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK
| | - Clare Bambra
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, UK.
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46
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Valladares A, Bornstein L, Botero N, Gold I, Sayanvala F, Weinstock D. From scary places to therapeutic landscapes: Voices from the community of people living with schizophrenia. Health Place 2022; 78:102903. [PMID: 36174464 DOI: 10.1016/j.healthplace.2022.102903] [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: 05/23/2022] [Revised: 08/16/2022] [Accepted: 08/24/2022] [Indexed: 11/19/2022]
Abstract
This article discusses how people living with schizophrenia experience, understand, and respond to their urban environment. Our study relies on experiential photo-voice data gathered with a sample of six people diagnosed with schizophrenia and living in non-institutional settings in Montréal, Canada, to identify how individuals in this community perceive the urban landscape. We adopt a therapeutic landscapes' framework that explores the urban fabric at three levels: physical, social, and symbolic. Research participants identified both health-denying and health-enhancing places within ordinary urban landscapes. Landscapes identified as health-denying are characterized by environmental stressors and loss of control, with construction sites an example highlighted by participants. Healing and restorative landscapes, as identified by participants, were physically attractive or quiet, socially safe and welcoming, and symbolically affirmative of one's identity, all factors worthy of further study. The findings are also policy-relevant: they suggest that people living with schizophrenia and their clinicians can develop strategies to make health-enhancing uses of urban landscapes; and that urban policies and practices can foster urban environments conducive to enhanced health and well-being, both for the community of people living with schizophrenia and the wider population of urban dwellers.
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Affiliation(s)
| | | | - Nicolás Botero
- McGill University, Department of Cognitive Science, Canada
| | - Ian Gold
- McGill University, Department of Philosophy, Canada
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Letellier N, Zamora S, Yang JA, Sears DD, Jankowska MM, Benmarhnia T. How do environmental characteristics jointly contribute to cardiometabolic health? A quantile g-computation mixture analysis. Prev Med Rep 2022; 30:102005. [PMID: 36245803 PMCID: PMC9562428 DOI: 10.1016/j.pmedr.2022.102005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 09/07/2022] [Accepted: 09/24/2022] [Indexed: 11/05/2022] Open
Abstract
Accumulating evidence links cardiometabolic health with social and environmental neighborhood exposures, which may contribute to health inequities. We examined whether environmental characteristics were individually or jointly associated with insulin resistance, hypertension, obesity, type 2 diabetes, and metabolic syndrome in San Diego County, CA. As part of the Community of Mine Study, cardiometabolic outcomes of insulin resistance, hypertension, BMI, diabetes, and metabolic syndrome were collected in 570 participants. Seven census tract level characteristics of participants' residential environment were assessed and grouped as follows: economic, education, health care access, neighborhood conditions, social environment, transportation, and clean environment. Generalized estimating equation models were performed, to take into account the clustered nature of the data and to estimate β or relative risk (RR) and 95 % confidence intervals (CIs) between each of the seven environmental characteristics and cardiometabolic outcomes. Quantile g-computation was used to examine the association between the joint effect of a simultaneous increase in all environmental characteristics and cardiometabolic outcomes. Among 570 participants (mean age 58.8 ± 11 years), environmental economic, educational and health characteristics were individually associated with insulin resistance, diabetes, obesity, and metabolic syndrome. In the mixture analyses, a joint quartile increase in all environmental characteristics (i.e., improvement) was associated with decreasing insulin resistance (β, 95 %CI: -0.09, -0.18-0.01)), risk of diabetes (RR, 95 %CI: 0.59, 0.36-0.98) and obesity (RR, 95 %CI: 0.81, 0.64-1.02). Environmental characteristics synergistically contribute to cardiometabolic health and independent analysis of these determinants may not fully capture the potential health impact of social and environmental determinants of health.
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Affiliation(s)
- Noémie Letellier
- Scripps Institution of Oceanography, UC San Diego, USA,Corresponding author.
| | - Steven Zamora
- Scripps Institution of Oceanography, UC San Diego, USA
| | - Jiue-An Yang
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, USA
| | - Dorothy D. Sears
- College of Health Solutions, Arizona State University, Phoenix, AZ, USA,Department of Medicine, UC San Diego, La Jolla, CA, USA,Moores Cancer Center, UC San Diego, La Jolla, CA, USA
| | - Marta M. Jankowska
- Population Sciences, Beckman Research Institute, City of Hope, 1500 E Duarte Rd, Duarte, CA 91010, USA
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Friesinger JG, Haugland SH, Vederhus JK. The significance of the social and material environment to place attachment and quality of life: findings from a large population-based health survey. Health Qual Life Outcomes 2022; 20:135. [PMID: 36088453 PMCID: PMC9463864 DOI: 10.1186/s12955-022-02045-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/31/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
There is an international public health interest in sustainable environments that promote human wellbeing. An individual’s bond to places, understood as place attachment (PA), is an important factor for quality of life (QoL). The material environment, such as access to nature (AtN), access to amenities (AtA), or noise, and the social environment, such as social support or loneliness, has the potential to influence PA. The aim of the present study was to explore the relationship between these factors and QoL.
Methods
The study relied on data from 28,047 adults from 30 municipalities in Southern Norway obtained from the Norwegian Counties Public Health Surveys in 2019. Latent regression analyses were used to examine the relationship between the material and social environmental factors and QoL, mediated by PA.
Results
We found a relationship between social and material environmental factors and PA. Higher AtN and AtA scores were related to an increase in PA, whereas higher perception of noise problems was related to decreased PA scores. When social environment factors were added to the model, they were even stronger predictors of PA and, in turn, QoL through mediated effects. We also found a strong positive association between PA and QoL (unstandardized β = 0.88, 95% CI = 0.87–0.90, p < 0.001). The whole model explained 83% of the variance in PA and 65% of the variance in QoL.
Conclusions
Taken together, the findings suggest the relevance of material and social environmental factors for PA and QoL. Therefore, research on public health and QoL should include place-sensitive variables.
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Patte M, Chaix B, Gerber P, Klein O, Perchoux C, Vallée J. [Environnement résidentiel et vieillissement en santé : le rôle de l'activité physique et de la participation sociale]. Can J Aging 2022; 41:348-362. [PMID: 35512791 DOI: 10.1017/s0714980821000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Le vieillissement démographique est un des défis majeurs du 21e siècle. Il pose directement la question du « vieillissement en santé », un processus aidant les personnes âgées à rester en bonne santé et indépendantes le plus longtemps possible. L'influence des facteurs environnementaux sur ce processus peut varier selon les individus et leurs comportements. L'enchevêtrement de ces facteurs représente un défi autant théorique que méthodologique. Cet article a pour objectifs i) de quantifier les associations entre l'environnement physique et social du quartier des personnes âgées et leur vieillissement en santé et ii) d'examiner si leur activité physique et leur participation sociale jouent un rôle de médiation dans ces associations. Si certaines caractéristiques du quartier relatives à la réputation, l'accès aux services, et la cohésion sociale sont associées au vieillissement en santé, il existe un soutien limité à l'idée que les comportements tiennent un rôle d'intermédiaire dans cette relation.
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Affiliation(s)
- Marion Patte
- Géographie-Cités - UMR 8504, Campus Condorcet 5, Cours des Humanités 93322 Aubervilliers Cedex, 75006, France
| | - Basile Chaix
- Inserm, UMR-S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique - Faculté de Médecine Site Saint-Antoine - 27, rue Chaligny 75012 Paris, France
| | - Philippe Gerber
- Luxembourg Institute of Socio-Economic Research, Maison des Sciences Humaines, 11, Porte des Sciences L-4366Esch-sur-Alzette / Belval, Luxembourg
| | - Olivier Klein
- Luxembourg Institute of Socio-Economic Research, Maison des Sciences Humaines, 11, Porte des Sciences L-4366Esch-sur-Alzette / Belval, Luxembourg
| | - Camille Perchoux
- Luxembourg Institute of Socio-Economic Research, Maison des Sciences Humaines, 11, Porte des Sciences L-4366Esch-sur-Alzette / Belval, Luxembourg
| | - Julie Vallée
- Géographie-Cités - UMR 8504, Campus Condorcet 5, Cours des Humanités 93322 Aubervilliers Cedex, 75006, France
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Seto CH, Graif C, Khademi A, Honavar VG, Kelling CE. Connected in health: Place-to-place commuting networks and COVID-19 spillovers. Health Place 2022; 77:102891. [PMID: 35970068 PMCID: PMC9365871 DOI: 10.1016/j.healthplace.2022.102891] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 02/08/2023]
Abstract
Biweekly county COVID-19 data were linked with Longitudinal Employer-Household Dynamics data to analyze population risk exposures enabled by pre-pandemic, country-wide commuter networks. Results from fixed-effects, spatial, and computational statistical approaches showed that commuting network exposure to COVID-19 predicted an area's COVID-19 cases and deaths, indicating spillovers. Commuting spillovers between counties were independent from geographic contiguity, pandemic-time mobility, or social media ties. Results suggest that commuting connections form enduring social linkages with effects on health that can withstand mobility disruptions. Findings contribute to a growing relational view of health and place, with implications for neighborhood effects research and place-based policies.
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Affiliation(s)
- Christopher H Seto
- Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA; Population Research Institute, Pennsylvania State University, University Park, PA, USA.
| | - Corina Graif
- Department of Sociology and Criminology, Pennsylvania State University, University Park, PA, USA; Population Research Institute, Pennsylvania State University, University Park, PA, USA.
| | - Aria Khademi
- College of Information Science and Technology, Pennsylvania State University, University Park, PA, USA
| | - Vasant G Honavar
- College of Information Science and Technology, Pennsylvania State University, University Park, PA, USA; Center for Big Data Analytics and Discovery Informatics, Pennsylvania State University, University Park, PA, USA; Institute for Computational and Data Sciences, Pennsylvania State University, University Park, PA, USA
| | - Claire E Kelling
- Department of Statistics, Pennsylvania State University, University Park, PA, USA
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