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Grismer M, Duval-Couetil N, Yi S, Dukes A. Insights from a COVID-era health needs assessment of rural Midwestern Latinos. ETHNICITY & HEALTH 2024:1-18. [PMID: 39097863 DOI: 10.1080/13557858.2024.2385108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 07/22/2024] [Indexed: 08/05/2024]
Abstract
Latino health and well-being are crucial to the growth and vibrancy of rural areas across the United States, particularly at a time when the demographics of many rural communities are transitioning from minority Latino to majority Latino populations. This manuscript details the findings of a study that explored the health and healthcare benefit status of 524 Latino households in rural Indiana during the COVID-19 pandemic. Via 20-minute, door-to-door interviews conducted by bilingual researchers, survey participants answered questions about access to healthcare services and benefits, dietary and safety habits, medical issues, and vaccination status. The study found that slightly more than half of those surveyed were enrolled in healthcare benefit plans; approximately a third were unsatisfied with their health/health status; almost two-thirds had not received a flu shot and were eating fast food/processed food on a daily basis. Top health concerns reported included: stress (52%), vision problems (34%), neck and back pain (30%), headaches/migraines (28%), anxiety and depression (28%) and weight problems (26%). The study also discovered that half of the respondents could not identify a primary healthcare provider (PCP) by name and that pregnant women faced a lack of resources for maternal health in the county where the study was conducted. The results indicate that Latinos in rural communities continue to endure significant health issues and barriers to healthcare. The study provides an excellent model of how a rural community can monitor the health of its residents, which can inform health interventions for underserved populations.
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Affiliation(s)
- Melinda Grismer
- Department of Curriculum & Instruction, Purdue University, West Lafayette, IN, USA
| | - Nathalie Duval-Couetil
- Department of Technology Leadership & Innovation, Purdue University, West Lafayette, IN, USA
| | - Soohyun Yi
- Department of Educational Psychology, Texas Tech University, Lubbock, TX, USA
| | - Austin Dukes
- School of Medicine, Indiana University, West Lafayette, IN, USA
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Ambriz E, Rojas N, Okoye OC, Calderon NM, Calderon L, Kogut K, Deardorff J, Torres JM. Resiliency and Barriers to Successful Aging Among Middle-Aged Mexican Immigrants Residing in a Rural Agricultural Community. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae103. [PMID: 38847491 PMCID: PMC11237991 DOI: 10.1093/geronb/gbae103] [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: 06/05/2023] [Indexed: 07/03/2024] Open
Abstract
OBJECTIVES The Latino population is one of the largest, most diverse, and fastest-growing demographic groups in the United States. Although Latinos enjoy longer life spans and reduced mortality risk relative to non-Hispanic Whites, they have higher rates of chronic health conditions such as diabetes and dementia and live more of their older years with poor health and disability. Such inequities point to the need for this research focused on examining resiliency strategies and barriers to successful aging among various U.S. Latino subgroups. METHODS This qualitative study used thematic content analysis to examine resiliency strategies and barriers to successful aging among Mexican immigrant women (n = 40) residing in an underserved agricultural community and entering mid-life (mean = 49 years old). RESULTS With regards to barriers to successful aging, 3 themes emerged: (1) stressful lifestyle in the United States compared to the participants' home countries; (2) stress from expectations at home; and (3) stress due to work and the various components around work. The following 4 resiliency strategies emerged: (1) family as a motivation for moving forward in life and focusing on the success of children; (2) having a positive mindset; (3) praying to God for strength to overcome obstacles; and (4) self-care. DISCUSSION Despite experiencing barriers to successful aging, participants practice various resiliency strategies to age successfully. Because many of the barriers identified are related to poverty-related stressors, systemic solutions addressing the social determinants of health are needed.
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Affiliation(s)
- Elizabeth Ambriz
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Nadia Rojas
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Obiora C Okoye
- Global Brain Health Institute (GBHI), University of California San Francisco, San Francisco, California, USA
| | - Norma M Calderon
- Center for Environmental Research and Community Health (CERCH), University of California Berkeley, Berkeley, California, USA
| | - Lucia Calderon
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Katherine Kogut
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Julianna Deardorff
- School of Public Health, University of California Berkeley, Berkeley, California, USA
| | - Jacqueline M Torres
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
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Müller C, Paulsen L, Bucksch J, Wallmann-Sperlich B. Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review. Int J Behav Nutr Phys Act 2024; 21:52. [PMID: 38702772 PMCID: PMC11067138 DOI: 10.1186/s12966-024-01598-3] [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: 01/21/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking. METHODS We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results. RESULTS Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting). CONCLUSIONS Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults. TRIAL REGISTRATION PROSPERO: CRD42021283508.
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Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Würzburg, Judenbühlweg 11, 97082, Würzburg, Germany.
| | - Lisa Paulsen
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
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Li M, Li Y, Liu Z, Hystad P, Rangarajan S, Tse LA, Lear SA, Ma Y, Chen M, Han G, Li R, Yusuf S, Liu L, Hu B, Li W. Associations of perceived built environment characteristics using NEWS questionnaires with all-cause mortality and major cardiovascular diseases: The prospective urban rural epidemiology (PURE)-China study. ENVIRONMENT INTERNATIONAL 2024; 187:108627. [PMID: 38636273 DOI: 10.1016/j.envint.2024.108627] [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: 12/14/2023] [Revised: 03/31/2024] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Despite increased literature focusing on the role of the built environment (BE) in health, few cohort studies have quantitatively analyzed neighborhood walkability environment in relation to the risk of death and cardiovascular disease (CVD). This longitudinal study aimed at evaluating the association between perceived BE attributeswith mortality and major CVD based on the Prospective Urban Rural Epidemiology study in China (PURE-China). METHODS The PURE-China study recruited 47,931 participants aged 35-70 years from 12 provinces of China between 2005 and 2009. The perceived BE information, including land use, street, aesthetics, and safety, was collected using the neighborhood environment walkability scale (NEWS) questionnaire, with higher scores indicating a more favorable rating. Two primary outcomes are all-cause mortality and major CVD event. The Cox frailty model with random intercepts was used to assess the association between the perceived total BE/subscales score and outcomes. RESULTS Of 32,163 participants included in this study, 19,253 (59.9 %) were women, and the mean (SD) age was 51.0 (9.5) years. After a median follow-up period of 11.7 years (IQR 9.4 - 12.2), we observed that one standard deviation higher of combined BE scores was related to a lower risk of all-cause mortality (HR = 0.85; 95 %CI, 0.80-0.90), and major CVD events (HR = 0.95; 95 %CI, 0.90-0.99). The subscales of perceived BE were related to a lower risk, although a few were not significant. Land use mix-diversity and safety from crime were the two most significant subscales. Stronger risks were observed among urban and female participants. CONCLUSION Favorable perceived BE characteristics were linked with a lower risk of all-cause mortality and major CVD events in Chinese population, especially in urban areas and females. Our findings can be used by policymakers to take action to mitigate the adverse effect of poor community conditions on health, such as improving local amenities and transport connectivity, providing building paths for walking, running and cycling.
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Affiliation(s)
- Mengya Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Yang Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China; Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Zhiguang Liu
- Clinical Trial Unit, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Perry Hystad
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, United States
| | - Sumathy Rangarajan
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lap Ah Tse
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR
| | - Scott A Lear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Yuanting Ma
- Dongguan Street Community Health Service Center, Xining, Qinghai Province, China
| | - Mengxin Chen
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Guoliang Han
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Ruotong Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China
| | - Salim Yusuf
- Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Lisheng Liu
- Beijing Hypertension League Institute, Beijing, China.
| | - Bo Hu
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China.
| | - Wei Li
- Medical Research & Biometrics Center, National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College & Chinese Academy of Medical Sciences Beijing, China.
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Fang Z, Lin Y, Chen C, Jiang J, Dong L. Mental health in China: exploring the impacts of built environment, work environment, and subjective perception. Front Psychol 2024; 15:1352609. [PMID: 38455120 PMCID: PMC10918749 DOI: 10.3389/fpsyg.2024.1352609] [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: 12/08/2023] [Accepted: 02/08/2024] [Indexed: 03/09/2024] Open
Abstract
Introduction The shifting living and working conditions have profound impacts on the residents' mental health. However, current research in this field has not remarkable investigated. Methods This study used the China Labor-force Dynamic Survey (CLDS) dataset from 2018 and relied on a regression model to examine the effects of the built environment, work environment, and subjective perception on the mental health of Chinese citizens. It also considers the circumstances of both migrants and local residents. Results This study revealed significant correlations between mental health and greening space rate, road network density, commuting time, work feelings, community trust, economic satisfaction, and other factors. Additionally, the mental health of local residents was shown to be significantly affected by community security, while it shows no significance in migrants. Furthermore, a significant spatial autocorrelation was found in terms of mental health within the central and eastern regions of China. Discussion The findings of this study offer valuable insights that can be used to facilitate measures aimed at improving the mental health of residents and promoting the development of healthy cities.
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Affiliation(s)
- Zhou Fang
- Guangzhou Transport Planning Research Institute Co., Ltd., Guangzhou, China
| | - Yu Lin
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Chuangyuan Chen
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Jian Jiang
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, Guangdong, China
| | - Letian Dong
- School of Architecture and Urban Planning, Guangdong University of Technology, Guangzhou, Guangdong, China
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Rodríguez-Guerrero LA, Pérez-Urdiales I, Escrig-Piñol A, Jiménez-Lasserrotte MDM, Pastor-Bravo MDM, Mateos JT, Briones-Vozmediano E. Water insecurity among seasonal agriculture workers: perspectives from Spanish professionals. Int J Equity Health 2024; 23:31. [PMID: 38365766 PMCID: PMC10874045 DOI: 10.1186/s12939-024-02112-8] [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: 06/29/2023] [Accepted: 01/18/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND Migrant seasonal agricultural workers face conditions of material vulnerability such as inadequate housing difficulties prevent access to running water supplies. The purpose of this study is to explore the perceptions of professionals involved in the care and support of seasonal migrant agricultural workers, as it relates to water access and water consumption and their impact on these workers' health, in a context of COVID-19 pandemic. METHODS A qualitative exploratory and descriptive study was conducted in 2021 as part of a larger research project, based on 63 personal semi-structured interviews with professionals who provided support to seasonal migrant agricultural workers in three Spanish autonomous regions. COREQ checklist was used for reporting. The interviews were recorded, transcribed, and imported into ATLAS.ti-9 for an inductive thematic analysis. RESULTS The results have been structured into two main themes: (1) Accessing and obtaining water; and (2) Health problems related to water consumption. Seasonal migrant agricultural workers experience barriers to obtaining safe water for hygiene, cleaning, food preparation and drinking. The implementation of regulations to reduce COVID-19 transmission resulted in improved hygiene levels in the migrants' quarters, including access to safe drinking water. CONCLUSION This study suggests that water insecurity experienced by migrant seasonal agricultural workers in Spain results from their poor living conditions and causes health problems related to a lack of hygiene and the use of unsafe water. Sustainable solutions are needed beyond the pandemic in order to provide migrant workers with adequate living conditions and ensure their water needs are fulfilled.
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Affiliation(s)
- Luis Alejandro Rodríguez-Guerrero
- Health Care Research Group (GRECS), Biomedical Research Institute (IRB) of Lleida, Dr. Pifarré Foundation, Lleida, Spain
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
| | - Iratxe Pérez-Urdiales
- Department of Nursing, University of the Basque Country, Member of the Biocruces Bizkaia Health Research Institute, Bizkaia, Spain
| | - Astrid Escrig-Piñol
- ESIMar (Mar Nursing School), Universitat Pompeu Fabra-affiliated, Parc de Salut Mar, Barcelona, Spain
- SDHEd (Social Determinants and Health Education Research Group), IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | - María Del Mar Pastor-Bravo
- Department of Nursing, University of Murcia, Cartagena, Murcia, Spain
- ENFERAVANZA, Biomedical Research Institute of Murcia (IMIB-Arrixaca), Murcia, Spain
| | - José Tomás Mateos
- Health Care Research Group (GRECS), Biomedical Research Institute (IRB) of Lleida, Dr. Pifarré Foundation, Lleida, Spain.
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain.
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain.
| | - Erica Briones-Vozmediano
- Health Care Research Group (GRECS), Biomedical Research Institute (IRB) of Lleida, Dr. Pifarré Foundation, Lleida, Spain
- Department of Nursing and Physiotherapy, University of Lleida, Lleida, Spain
- Society, Health, Education and Culture Research Group (GESEC), University of Lleida, Lleida, Spain
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Ambriz E, De Pierola C, Calderon NM, Calderon L, Kogut K, Deardorff J, Torres JM. Definitions of successful aging among middle-aged Latinas residing in a rural agricultural community. PLoS One 2023; 18:e0294887. [PMID: 38032988 PMCID: PMC10688629 DOI: 10.1371/journal.pone.0294887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/11/2023] [Indexed: 12/02/2023] Open
Abstract
INTRODUCTION Latinos are the fastest growing aging population in the U.S. However, there has been limited attention to conceptualizing successful aging among Latinos, especially those residing in rural communities. Latinos are the largest racial or ethnic group residing in rural underserved communities and rural Latinos experience significant structural barriers to access the conditions they need to age well. The goal of this study is to make unique contributions to the successful aging literature by describing what successful aging means for middle-aged Latinas residing in a rural community. METHODS This qualitative paper used inductive thematic content analysis to examine definitions of successful aging among Latina women (n = 40) residing in an underserved agricultural community and entering mid-life (mean = 49 years old; age range 40-64). RESULTS With regards to definitions of successful aging, four themes emerged: 1) Having good health; 2) maintaining an active lifestyle; 3) the wellbeing of one's children; and 4) being independent. DISCUSSION Participants' definitions of successful aging aligned to some extent with existing frameworks, specifically related to health and independence. However, middle-aged Latina participants' unique definitions of successful aging also diverged from existing frameworks, especially around the wellbeing of their children and the importance of work as a way of maintaining an active lifestyle. More research is needed to understand the unique social context and circumstances of middle-aged Latinos residing in rural communities and how they influence their aging journeys. This can provide important information for the development of culturally sensitive services, interventions, and policies to help Latinos age well.
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Affiliation(s)
- Elizabeth Ambriz
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Camila De Pierola
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Norma M. Calderon
- Center for Environmental Research and Community Health (CERCH), University of California Berkeley, Berkeley, California, United States of America
| | - Lucia Calderon
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Katherine Kogut
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Julianna Deardorff
- School of Public Health, University of California Berkeley, Berkeley, California, United States of America
| | - Jacqueline M. Torres
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, United States of America
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Santoyo-Olsson J, Stewart AL, Ortiz C, Palomino H, Torres-Nguyen A, Coleman L, Alhomsi A, Quintero S, Bonilla J, Santana-Ufret V, Nápoles AM. Evaluating the implementation of Nuevo Amanecer-II in rural community settings using mixed methods and equity frameworks. Arch Public Health 2023; 81:194. [PMID: 37946287 PMCID: PMC10633986 DOI: 10.1186/s13690-023-01207-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The 10-week Nuevo Amanecer-II intervention, tested through a randomized controlled trial, reduced anxiety and improved stress management skills among Spanish-speaking Latina breast cancer survivors. This paper describes the implementation and equity evaluation outcomes of the Nuevo Amanecer-II intervention delivered in three California rural communities. METHODS Using implementation and equity frameworks, concurrent convergent mixed methods were applied to evaluate implementation (feasibility, fidelity, acceptability, adoption, appropriateness, and sustainability) and equity (shared power and capacity building) outcomes. Quantitative data were collected using tracking forms, fidelity rating forms, and program evaluation surveys; qualitative data were collected using semi-structured in-depth interviews. Respondents included community-based organization (CBO) administrators, recruiters, compañeras (interventionists), and program participants. RESULTS Of 76 women randomized to the intervention, 65 (86%) completed at least 7 of 10 sessions. Participants' knowledge (85% correct of 7 questions) and skills mastery were high (85% able to correctly perform 14 skills). Mean fidelity ratings across compañeras ranged from 3.8 (modeled skills) to 5.0 (used supportive/caring communication); 1-5 scale. The program was rated as very good/excellent by 90% of participants. Participants and compañeras suggested including family members; compañeras suggested expanding content on managing thoughts and mood and healthy living and having access to participant's survivorship care plan to tailor breast cancer information. CBOs adopted the program because it aligned with their priority populations and mission. Building on CBOs' knowledge, resources, and infrastructure, implementation success was due to shared power, learning, responsibility, and co-ownership, resulting in a co-created tailored program for community and organizational contexts. Building intervention capacity prior to implementation, providing funding, and ongoing technical support to CBOs were vital for fidelity and enhancement of recruiter and compañera professional skills. Two of three CBOs created plans for program sustainability beyond the clinical trial; all administrators discussed the need for new funding sources to sustain the program as delivered. CONCLUSIONS Building on community assets and using equitable participatory research processes were central to the successful implementation of a peer-delivered psychosocial intervention in three rural communities among Spanish-speaking Latinas with breast cancer.
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Affiliation(s)
- Jasmine Santoyo-Olsson
- Division of Internal Medicine, University of California San Francisco, San Francisco, CA, USA.
| | - Anita L Stewart
- Institute for Health & Aging, University of California San Francisco, San Francisco, CA, USA
| | - Carmen Ortiz
- Circulo de Vida Cancer Support and Resource Center, San Francisco, CA, USA
| | - Helen Palomino
- Cancer Resource Center of the Desert, El Centro, CA, USA
| | | | - LaVerne Coleman
- WomenCARE/Entre Nosotras, Family Service Agency of the Central Coast, Watsonville, CA, USA
| | - Alia Alhomsi
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Stephanie Quintero
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Jackie Bonilla
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Veronica Santana-Ufret
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
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Arnold TJ, Arcury TA, Quandt SA, Sandberg JC, Talton JW, Daniel SS. Understanding Latinx Child Farmworkers' Reasons for Working: A Mixed Methods Approach. JOURNAL OF ADOLESCENT RESEARCH 2023; 38:1142-1176. [PMID: 38235371 PMCID: PMC10794015 DOI: 10.1177/07435584221144956] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Agricultural labor is extremely hazardous, yet young children are legally permitted to work on farms. This paper contextualizes and describes Latinx hired child farmworkers’ stated reasons for working. We conducted a mixed-methods study using in-depth interviews ( n = 30) and survey interviews ( n = 202) with Latinx child farmworkers aged 10 to 17 in North Carolina. Our qualitative thematic analysis identified children’s salient reasons for working, including supporting family, contextual factors that lead to farm work, and occupying summer time. Statistical analysis showed that children’s primary reasons for working included buying clothes (91.1%) and school supplies (64.7%), with few differences by gender, age, or other characteristics. The findings demonstrate that most Latinx children view farm work as a necessary but temporary experience that financially supports their families. We discuss the implications for protecting Latinx child workers by reducing their structural vulnerability in order to facilitate healthy development.
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Affiliation(s)
- Taylor J. Arnold
- Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Thomas A. Arcury
- Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Sara A. Quandt
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine
| | - Joanne C. Sandberg
- Department of Family and Community Medicine, Wake Forest University School of Medicine
| | - Jennifer W. Talton
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine
| | - Stephanie S. Daniel
- Department of Family and Community Medicine, Wake Forest University School of Medicine
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Rhubart D, Kowalkowski J, Wincott L. The Built Environment and Social and Emotional Support among Rural Older Adults: The Case for Social Infrastructure and Attention to Ethnoracial Differences. RURAL SOCIOLOGY 2023; 88:731-762. [PMID: 37829666 PMCID: PMC10567077 DOI: 10.1111/ruso.12491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 05/01/2023] [Indexed: 10/14/2023]
Abstract
Social and emotional support (SaES) is essential for older adult mental health and is shaped by individual-level factors and the built environment. However, much of the focus on the built environment, and specifically social infrastructure - the physical places that facilitate social interaction and social tie formation - relies heavily on urban settings or samples with limited diversity. Consequently, there is little understanding if social infrastructure matters for the SaES of older adults in rural America, and across race and ethnicity. Therefore, we use social cohesion as a conceptual lens and the community gerontology framework to determine if availability of social infrastructure is associated with SaES among older adults in rural America and if this relationship varies across race and ethnicity. Using data from 110,850 rural older adults from the Behavioral Risk Factors Surveillance System and data from the National Neighborhood Data Archive, we show that among rural ethnoracial minority older adults, higher densities of social infrastructure are associated with higher SaES. This is not true for rural non-Hispanic White older adults. Results highlight the importance of accounting for both social infrastructure as part of the built environment and heterogeneity across race and ethnicity in studies that examine older adult mental and emotional health.
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Affiliation(s)
- Danielle Rhubart
- The Pennsylvania State University, Biobehavioral Health Building, University Park PA 16802, USA
| | - Jennifer Kowalkowski
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - Logan Wincott
- The Pennsylvania State University, University Park, PA, USA
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Stern M, Rancourt D, Soca Lozano S, Buro AW, Gray HL, Rodriguez C, Bailey R, Redwine L. Delivering ADAPT+ to Latino Families Living in Rural Communities: Feasibility and Acceptability of Implementing a Health Promotion Program Including Mindfulness. J Pediatr Psychol 2023; 48:666-675. [PMID: 37541829 PMCID: PMC10468101 DOI: 10.1093/jpepsy/jsad049] [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: 04/21/2023] [Revised: 07/19/2023] [Accepted: 07/19/2023] [Indexed: 08/06/2023] Open
Abstract
BACKGROUND Obesity is a major public health crisis in Latino youth. Mounting evidence implicates stress in the development and maintenance of obesity. This study examined the feasibility and acceptability of having community health workers, i.e., promotoras, deliver Adaptando Dieta y Acción Para Todos (ADAPT)+, a family-based health promotion program integrating mindfulness strategies for stress reduction to underserved Latino families in rural communities. METHODS In an ORBIT model Phase IIb longitudinal quasi-cluster feasibility study, promotoras delivered the 6-session ADAPT+ intervention and 1-session Enhanced Usual Care (EUC) in rural Florida. Feasibility was assessed via sample size and recruitment, randomization by community, data collection completion, and intervention fidelity. Acceptability was assessed via participant retention and program satisfaction. Effect sizes of differences in parent stress and mindful eating between conditions at baseline, end of treatment, and 3-month follow-up were calculated. RESULTS Feasibility and acceptability were demonstrated. The recruitment target was 99% met (n = 95 recruited). Randomization was limited to site level due to coronavirus disease 2019-related challenges. Data collection procedures were feasible (100% completion). Retention was 86% at post-assessment and 82.6% at 3-month follow-up. All sessions were completed (100% fidelity). Mean program satisfaction was 3.91/4.00. ADAPT+ parents reported lower stress (difference = -3.04, medium-to-large effect, d = .70) and more mindful eating (difference = 2.00, medium effect, d = .44) than EUC parents at 3-month follow-up. CONCLUSION Study implementation and intervention delivery to rural Latino families using promotoras were feasible and acceptable. Promising findings regarding parent stress and mindful eating support a larger (ORBIT Phase III) efficacy trial. CLINICAL TRIAL REGISTRATION This trial was registered with ClinicalTrials.gov under identifier NCT04800432.
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Affiliation(s)
- Marilyn Stern
- Department of Child and Family Studies, College of Behavioral and Community Sciences, University of South Florida, USA
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, USA
| | - Diana Rancourt
- Department of Psychology, University of South Florida, USA
| | | | - Acadia W Buro
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, USA
| | - Heewon L Gray
- College of Public Health, University of South Florida, USA
| | | | | | - Laura Redwine
- Department of Family Medicine and Community Health, Miller School of Medicine, University of Miami, USA
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12
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Santoyo-Olsson J, Stewart AL, Nápoles AM. Financial strain, neighborhood cohesion, and health-related quality of life among rural and urban Spanish-speaking Latina breast cancer survivors. J Cancer Surviv 2023:10.1007/s11764-023-01369-2. [PMID: 36991270 DOI: 10.1007/s11764-023-01369-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 03/18/2023] [Indexed: 03/31/2023]
Abstract
PURPOSE Among Latina breast cancer survivors, explore associations between rural/urban residence and health-related quality of life (HRQL), and whether associations are moderated by financial strain and low neighborhood cohesion. METHODS We combined baseline data from two randomized controlled trials of a stress management intervention conducted among 151 urban and 153 rural dwelling Latinas with nonmetastatic breast cancer. Generalized linear models estimated associations between rural/urban status and HRQL (overall, emotional, social-family, physical, and functional well-being), and we examined moderation effects of financial strain and low neighborhood cohesion, controlling for age, marital status, and breast cancer characteristics. RESULTS Rural women reported better emotional (β = 1.85; 95% CI = 0.37, 3.33), functional (β = 2.23; 95% CI = 0.69, 3.77), and overall (β = 5.68; 95% CI = 1.12, 10.25) well-being than urban women, regardless of degree of financial strain or neighborhood cohesion; moderation effects were not statistically significant. Financial strain was inversely associated with emotional (β = -2.34; 95% CI = 3.63, -1.05), physical (β = -2.56; 95% CI = -4.12, -1.01), functional (β = -1.61; 95% CI = -2.96, -0.26), and overall (β = -6.67; 95% CI = -10.96, -2.98) well-being. Low neighborhood cohesion was inversely associated with emotional (β = -1.27; 95% CI = -2.50, -0.04), social-family (β = -1.72; 95% CI = -3.02, -0.42), functional (β = -1.63; 95% CI = -2.92, -0.34), and overall (β = -5.95; 95% CI = 9.76, -2.14) well-being. CONCLUSIONS Rural Latina breast cancer survivors reported better emotional, functional and overall well-being than their urban counterparts. Greater financial strain and less neighborhood cohesion were associated with worse HRQL on most domains regardless of rural/urban context. IMPLICATIONS FOR CANCER SURVIVORS Interventions that focus on increasing perceived neighborhood cohesion and reducing or better managing financial strain, could help improve Latina cancer survivors' well-being.
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Affiliation(s)
- Jasmine Santoyo-Olsson
- University of California San Francisco, Division of Internal Medicine, 490 Illinois Street, 9th floor, Box 0856, San Francisco, CA, 94158, USA.
- University of California Berkeley, School of Public Health, 2121 Berkeley Way, Room 5302, Berkeley, CA, 94720, USA.
| | - Anita L Stewart
- University of California San Francisco, Institute for Health & Aging, Center for Aging in Diverse Communities, 490 Illinois Street, 12th floor, Box 0646, San Francisco, CA, 94158, USA
| | - Anna María Nápoles
- Division of Intramural Research, National Institute On Minority Health and Health Disparities, National Institutes of Health, 9000 Rockville Pike, Building 3, Floor 5, Room E08, Bethesda, MD, 20892, USA
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13
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Valdez A, Cepeda A, Frankeberger J, Nowotny KM. The opioid epidemic among the Latino population in California. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 2:100029. [PMID: 36845892 PMCID: PMC9948808 DOI: 10.1016/j.dadr.2022.100029] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 01/26/2022] [Accepted: 01/27/2022] [Indexed: 11/28/2022]
Abstract
Background The opioid epidemic in the United States has manifested differently across geographic regions and populations, with recent increases among racial/ethnic minorities and in the Western region of the U.S. This study provides an overview of the opioid overdose epidemic among Latinos in California and highlights high-risk areas in the state. Methods Using publicly available data from California, we examined trends in opioid-related deaths (e.g., overdose) and opioid-related emergency department (ED) visits among Latinos at the county-level, as well as changes in opioid outcomes overtime. Results Opioid-related death rates among Latinos (mostly Mexican-origin) in California remained relatively stable from 2006-2016, but started to increase in 2017 peaking at an age-adjusted opioid mortality rate of 5.4 deaths per 100,000 Latino residents in 2019. Prescription opioid-related deaths, compared to heroin and fentanyl, have remained the highest over time. However, fentanyl-related deaths began to increase dramatically in 2015. Lassen, Lake, and San Francisco counties had the highest 2019 opioid-related death rates among Latinos. Opioid-related ED visits among Latinos have steadily increased since 2006 with a sharp increase in rates in 2019. San Francisco, Amador, and Imperial counties had the highest 2019 rates of ED visits. Conclusions Latinos are facing detrimental consequences associated with recent increasing trends in opioid overdoses. The identified high-risk counties may have vulnerable sub-populations of Latinos, such as those in northern rural regions, that have gone underrepresented in conventional surveillance health databases. Time sensitive policies and interventions are needed to curtail health consequences especially among "hidden" Latino populations.
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Affiliation(s)
- Avelardo Valdez
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Montgomery Ross Fisher Building, 669 W. 34th St., Los Angeles, CA 90089, USA,Corresponding author.
| | - Alice Cepeda
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Montgomery Ross Fisher Building, 669 W. 34th St., Los Angeles, CA 90089, USA
| | - Jessica Frankeberger
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, 130 De Soto Street, Pittsburgh, PA 15261, USA
| | - Kathryn M. Nowotny
- Department of Sociology, University of Miami, 5202 University Dr., Merrick Building 120, Coral Gables, FL 33146, USA
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Arcury TA, Chen H, Quandt SA, Talton JW, Anderson KA, Scott RP, Jensen A, Laurienti PJ. Pesticide exposure among Latinx children: Comparison of children in rural, farmworker and urban, non-farmworker communities. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 763:144233. [PMID: 33385842 PMCID: PMC7855950 DOI: 10.1016/j.scitotenv.2020.144233] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 05/05/2023]
Abstract
Personal pesticide exposure is not well characterized among children in vulnerable, immigrant communities. We used silicone wristbands in 2018-2019 to assess pesticide exposure in 8 year old Latinx boys and girls in rural, farmworker families (n = 73) and urban, non-farmworker families (n = 60) living in North Carolina who were enrolled in the PACE5 Study, a community-based participatory research study. We determined the detection and concentrations (ng/g) of 75 pesticides and pesticide degradation products in the silicone wristbands worn for one week using gas chromatography electron capture detection and employed gas chromatography mass spectrometry. Differences by personal and family characteristics were tested using analysis of variance or Wilcoxon Rank Sum tests when necessary. Pesticide concentrations above the limit of detection were analyzed, and reported as geometric means and 95% confidence intervals (CI). The most frequently detected pesticide classes were organochlorines (85.7%), pyrethroids (65.4%), and organophosphates (59.4%), with the most frequently detected specific pesticides being alpha-chlordane (69.2%), trans-nonachlor (67.7%), gamma-chlordane (66.2%), chlorpyrifos (54.9%), cypermethrin (49.6%), and trans-permethrin (39.1%). More of those children in urban, non-farmworker families had detections of organochlorines (93.3% vs. 79.5, p = 0.0228) and pyrethroids (75.0% vs. 57.5%, p = 0.0351) than did those in rural, farmworker families; more children in rural, farmworker families had detections for organophosphates (71.2% vs. 45.0%, p= 0.0022). Children in urban, non-farmworker families had greater concentrations of alpha-chlordane (geometric mean (GM) 18.98, 95% CI 14.14, 25.47 vs. 10.25, 95% CI 7.49, 14.03; p= 0.0055) and dieldrin (GM 17.38, 95% CI 12.78 23.62 vs. 8.10, 95% CI 5.47, 12.00; p= 0.0034) than did children in rural, farmworker families. These results support the position that pesticides are ubiquitous in the living environment for children in vulnerable, immigrant communities, and argue for greater effort in documenting the widespread nature of pesticide exposure among children, with greater effort to reduce pesticide exposure.
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Affiliation(s)
- Thomas A Arcury
- Department of Family and Community Medicine, Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Haiying Chen
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Sara A Quandt
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Center for Worker Health, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Jennifer W Talton
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
| | - Kim A Anderson
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA.
| | - Richard P Scott
- Department of Environmental and Molecular Toxicology, Oregon State University, 2750 SW Campus Way, Corvallis, OR 97331, USA.
| | - Anna Jensen
- North Carolina Farmworkers Project, 1238 NC Highway 50 S, Benson, NC 27504, USA.
| | - Paul J Laurienti
- Department of Radiology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
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Greder K, Zaman A, Routh B, Hammons A, Villegas E. Rural Midwestern Mexican Fathers' Perspectives on Family Food, Mealtimes, and Physical Activity. Ecol Food Nutr 2020; 60:409-434. [PMID: 33334199 DOI: 10.1080/03670244.2020.1858408] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Two focus group interviews with eight low-income Mexican fathers in two communities in a rural Midwestern state explored fathers' perceptions, behaviors, and roles related to child and family food consumption, mealtimes, and physical activity. On average, fathers were 34 years of age, had 10 years of formal education, and annual household incomes ranged from $36,250 to $46,249. Findings include the identification of fifteen themes through the process of thematic analysis that are organized by five thematic areas of interest (family food patterns, strategies for healthy eating, family roles in food shopping and preparation, family mealtimes, physical activity among families). Findings revealed ways fathers contributed to their children's and families' health and well-being, and challenges they faced. Health promotion efforts aimed at rural, low-income Mexican immigrant families can benefit from embracing fathers' perspectives and how they influence the health and well-being of their children and families.
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Affiliation(s)
- Kimberly Greder
- Department of Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| | - Andrew Zaman
- Department of Kinesiology and Department of Psychology, Iowa State University, Ames, Iowa, USA
| | - Brianna Routh
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
| | - Amber Hammons
- Department of Child and Family Science, California State University, Fresno, California, USA
| | - Elizabeth Villegas
- Department of Education and Child Development, University of Chicago, Chicago, Illinois, USA
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Wang P, Goggins WB, Zhang X, Ren C, Lau KKL. Association of urban built environment and socioeconomic factors with suicide mortality in high-density cities: A case study of Hong Kong. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 739:139877. [PMID: 32534310 DOI: 10.1016/j.scitotenv.2020.139877] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 05/23/2023]
Abstract
Population ageing, climate change and urbanization have been occurring rapidly globally. Evidence-based healthy city development is required to improve living quality and mitigate the adverse impact of city living on both physical and mental health. We took a high-density city as an example to explore the association of built environment and suicide mortality and preferably to offer some implications for better future city development. Poisson generalized linear models with generalized estimation equations were employed to regress suicide mortality rate on four urban built environment variables (frontal area density (FAD), sky view factor (SVF), ground coverage ratio (GCR), and street coverage ratio (SCR)), as well as socioeconomic factors, population density, and greenery. The association for different causes of death and within different subgroups was also investigated. Generally, higher FAD and GCR were associated with higher suicide mortality while higher SVF and SCR were associated with lower suicide mortality. Age was a significant effect modifier. An interquartile range increase in FAD, SVF, and GCR was associated with 0.81 (95% confidence interval (CI) 0.71-0.92), 1.41 (95% CI 1.04-1.91), and 0.70 (95% CI 0.50-0.98) times the risk of suicide among the people aged over 70, respectively. Higher population density and unmarried status were generally associated with higher suicide rate whereas higher education level was associated with a decreased risk. Unfavorable built environment could increase risks for successful suicide attempts. Better urban development with morphological control mitigating intensifying urban heat island and other micro-environment changes are warranted to promote not only physical but psychological health.
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Affiliation(s)
- Pin Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China
| | - William B Goggins
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, N.T., Hong Kong, China.
| | - Xuyi Zhang
- Faculty of Architecture, The University of Hong Kong, 4/F, Knowles Building, Pokfulam Road, Hong Kong, China
| | - Chao Ren
- Faculty of Architecture, The University of Hong Kong, 4/F, Knowles Building, Pokfulam Road, Hong Kong, China
| | - Kevin Ka-Lun Lau
- Institute of Future Cities, Chung Chi College, The Chinese University of Hong Kong, Room 406B, Wong Foo Yuan Building, Shatin, New Territories, Hong Kong, China
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Tulimiero M, Garcia M, Rodriguez M, Cheney AM. Overcoming Barriers to Health Care Access in Rural Latino Communities: An Innovative Model in the Eastern Coachella Valley. J Rural Health 2020; 37:635-644. [PMID: 32603004 DOI: 10.1111/jrh.12483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Latino farmworkers lack access to basic needs, including health care services. These farmworkers face barriers common to rural areas (eg, limited health services and public transportation), as well as language barriers, an unfamiliar medical system, no health insurance, and income-based financial challenges exacerbated by a lack of workers' rights. METHODS This study involved focus group discussions to elicit community health priorities and barriers to health care service use among Latinos in rural farm working communities, as well as participants' ideal model for health care services delivery. Free mobile clinics were subsequently implemented at locations and times the community identified as ideal, and pre- and postinterviews of patients' experiences utilizing clinic services, and perceptions of access barriers, were conducted. RESULTS Results from focus group discussions (n = 82) and one-on-one interviews (n = 15) to evaluate mobile clinic health care services use confirmed documented barriers to health care for this population, shed light on structural and cultural barriers to service access, and suggested innovative models for service delivery to Spanish-speaking Latino farmworkers in rural communities. These models should (1) provide care within farm working communities, (2) offer services at times outside of business hours, and (3) encourage provider immersion in patient communities to better understand their health care needs. DISCUSSION Traditional models of care that expect patients to access health care services at brick and mortar structures are impractical for Latino farmworkers in rural communities. Innovative models bringing health care services to community spaces can reduce access barriers and emergency department utilization and improve health outcomes for this structurally vulnerable population.
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Affiliation(s)
- Monica Tulimiero
- Department of Family Medicine, Ventura County Medical Center, Ventura, California
| | - Michael Garcia
- Department of Psychiatry and Neuroscience, University of California Riverside, Riverside, California
| | - Maria Rodriguez
- Department of Anthropology, University of California Riverside, Riverside, California
| | - Ann M Cheney
- Department of Social Medicine Population and Public Health, School of Medicine, University of California Riverside, Riverside, California
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Overview of "Systematic Reviews" of the Built Environment's Effects on Mental Health. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2020; 2020:9523127. [PMID: 32256618 PMCID: PMC7106933 DOI: 10.1155/2020/9523127] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 12/04/2019] [Accepted: 02/21/2020] [Indexed: 01/08/2023]
Abstract
Good mental health is related to mental and psychological well-being, and there is growing interest in the potential role of the built environment on mental health, yet the evidence base underpinning the direct or indirect effects of the built environment is not fully clear. The aim of this overview is to assess the effect of the built environment on mental health-related outcomes. Methods. This study provides an overview of published systematic reviews (SRs) that assess the effect of the built environment on mental health. We reported the overview according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Databases searched until November 2019 included the Cochrane Database of Systematic Reviews, EMBASE, MEDLINE (OVID 1946 to present), LILACS, and PsycINFO. Two authors independently selected reviews, extracted data, and assessed the methodological quality of included reviews using the Assessing Methodological Quality of Systematic Reviews-2 (AMSTAR-2). Results. In total, 357 records were identified from a structured search of five databases combined with the references of the included studies, and eleven SRs were included in the narrative synthesis. Outcomes included mental health and well-being, depression and stress, and psychological distress. According to AMSTAR-2 scores, the quality assessment of the included SRs was categorized as "high" in two SRs and as "critically low" in nine SRs. According to the conclusions of the SRs reported by the authors, only one SR reported a "beneficial" effect on mental health and well-being outcomes. Conclusion. There was insufficient evidence to make firm conclusions on the effects of built environment interventions on mental health outcomes (well-being, depression and stress, and psychological distress). The evidence collected reported high heterogeneity (outcomes and measures) and a moderate- to low-quality assessment among the included SRs.
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