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Kim J, Green J, McIntyre E, Standen C. Considering Residents' Health and Well-Being in the Process of Social Housing Redevelopment: A Rapid Scoping Literature Review. J Urban Health 2024:10.1007/s11524-024-00915-2. [PMID: 39269665 DOI: 10.1007/s11524-024-00915-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2024]
Abstract
Many aging mid-twentieth-century social housing developments worldwide are set to undergo major redevelopment, aiming to improve residents' living conditions. Nevertheless, the associated processes, particularly the challenges of relocation during the demolition and reconstruction phase, can significantly disrupt communities and social networks. Understanding the multifaceted impacts of social housing redevelopment projects is crucial to inform planning, design, and consultation for these projects. This scoping literature review explores how residents' health and well-being are considered in the process of social housing redevelopment. We identified eight studies through a search performed on EMBASE, PubMed, and Scopus databases, with an additional hand search of the bibliographies of selected studies. A thematic analysis was conducted to identify the health and well-being impacts of the different phases during redevelopment projects. The findings demonstrate that social housing redevelopment projects have varied impacts on residents' health and well-being depending on the subgroup of residents and the contextual characteristics of the original social housing estate. While improved physical infrastructure provides opportunities for better health outcomes, the disruption and lack of control during the relocation process may cause significant adverse health impacts. Moreover, the different phases during the redevelopment process expose different subgroups to varying risks. Based on these findings, we recommend that social housing redevelopment initiatives prioritize engaging and empowering residents to have better control in decision-making throughout all phases of the redevelopment.
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Affiliation(s)
- Jinhee Kim
- Cities Institute, University of New South Wales, Sydney, Australia.
| | - Jennifer Green
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Collective for Midwifery, Child and Family Health, Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Erica McIntyre
- Institute for Sustainable Futures, University of Technology Sydney, Sydney, Australia
- Research Institute for Innovative Solutions for Well-Being and Health (INSIGHT), Faculty of Health, University of Technology Sydney, Sydney, Australia
| | - Christopher Standen
- Centre for Primary Health Care and Equity, University of New South Wales, Sydney, Australia
- Health Equity Research and Development Unit, Sydney Local Health District, Sydney, Australia
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DeMass R, Gupta D, Self S, Thomas D, Rudisill C. Emergency department use and geospatial variation in social determinants of health: a pilot study from South Carolina. BMC Public Health 2023; 23:1527. [PMID: 37563566 PMCID: PMC10416539 DOI: 10.1186/s12889-023-16136-2] [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: 02/24/2023] [Accepted: 06/16/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Health systems are increasingly addressing patients' social determinants of health (SDoH)-related needs and investigating their effects on health resource use. SDoH needs vary geographically; however, little is known about how this geographic variation in SDoH needs impacts the relationship between SDoH needs and health resource use. METHODS This study uses data from a SDoH survey administered to a pilot patient population in a single health system and the electronic medical records of the surveyed patients to determine if the impact of SDoH needs on emergency department use varies geospatially at the US Census block group level. A Bayesian zero-inflated negative binomial model was used to determine if emergency department visits after SDoH screening varied across block groups. Additionally, the relationships between the number of emergency department visits and the response to each SDoH screening question was assessed using Bayesian negative binomial hurdle models with spatially varying coefficients following a conditional autoregressive (CAR) model at the census block group level. RESULTS Statistically important differences in emergency department visits after screening were found between block groups. Statistically important spatial variation was found in the association between patient responses to the questions concerning unhealthy home environments (e.g. mold, bugs/rodents, not enough air conditioning/heat) or domestic violence/abuse and the mean number of emergency department visits after the screen. CONCLUSIONS Notable spatial variation was found in the relationships between screening positive for unhealthy home environments or domestic violence/abuse and emergency department use. Despite the limitation of a relatively small sample size, sensitivity analyses suggest spatially varying relationships between other SDoH-related needs and emergency department use.
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Affiliation(s)
- Reid DeMass
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915 Greene St., Columbia, SC, 29208, USA
| | - Deeksha Gupta
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Stella Self
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 300 E. McBee Ave. Greenville, Columbia, SC, 29601, USA.
| | - Darin Thomas
- Addiction Medicine Center, Prisma Health, 605 Grove Road Greenville, Columbia, SC, 29605, USA
| | - Caroline Rudisill
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, 300 E. McBee Ave. Greenville, Columbia, SC, 29601, USA
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Ellen IG, Dragan KL, Glied S. Renovating Subsidized Housing: The Impact On Tenants' Health. Health Aff (Millwood) 2021; 39:224-232. [PMID: 32011948 DOI: 10.1377/hlthaff.2019.00767] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Many public and subsidized housing developments in the US are aging and in need of significant repairs. Some observers worry that their poor condition threatens the health of residents. We evaluated a recent renovation of public housing that was undertaken through the transfer of six housing developments from the New York City Housing Authority to a public-private partnership. We studied whether the renovation and transfer to private managers led to improvements in tenants' health over three years, as measured by Medicaid claims. While we did not find significant improvements in individual health outcomes, we found significant relative improvements in overall disease burden when measured using an index of housing-sensitive conditions. These findings are not surprising. Given that broad-based housing renovations address a diverse set of health conditions, we should not expect them to have a significant impact on any single condition in the short run. Yet they may significantly improve residents' overall well-being over time.
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Affiliation(s)
- Ingrid Gould Ellen
- Ingrid Gould Ellen is the Paulette Goddard Professor of Urban Policy and Planning and faculty director of the NYU Furman Center, both in the Robert F. Wagner Graduate School of Public Service, New York University, in New York City
| | - Kacie L Dragan
- Kacie L. Dragan was a lead analyst for the Policies for Action Research Hub in the Robert F. Wagner Graduate School of Public Service, New York University, when the article was submitted. She is now a PhD candidate in health policy at the Harvard University Graduate School of Arts and Sciences, in Cambridge, Massachusetts
| | - Sherry Glied
- Sherry Glied ( sg162@nyu. edu ) is a professor of public service and dean of the Robert F. Wagner Graduate School of Public Service, New York University
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Gusmano MK, Rodwin VG, Weisz D. Medicare Beneficiaries Living In Housing With Supportive Services Experienced Lower Hospital Use Than Others. Health Aff (Millwood) 2018; 37:1562-1569. [DOI: 10.1377/hlthaff.2018.0070] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Michael K. Gusmano
- Michael K. Gusmano is an associate professor of health policy at Rutgers University and a research scholar at the Hastings Center, a nonprofit bioethics research institute in Garrison, New York
| | - Victor G. Rodwin
- Victor G. Rodwin is a professor of health policy and management in the Robert F. Wagner Graduate School of Public Service, New York University, in New York City
| | - Daniel Weisz
- Daniel Weisz is an adjunct associate research scientist at the School of Public Health, Columbia University, in New York City
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Hinds AM, Bechtel B, Distasio J, Roos LL, Lix LM. Changes in healthcare use among individuals who move into public housing: a population-based investigation. BMC Health Serv Res 2018; 18:411. [PMID: 29871635 PMCID: PMC5989341 DOI: 10.1186/s12913-018-3109-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 04/11/2018] [Indexed: 01/29/2023] Open
Abstract
Background Residence in public housing, a subsidized and managed government program, may affect health and healthcare utilization. We compared healthcare use in the year before individuals moved into public housing with usage during their first year of tenancy. We also described trends in use. Methods We used linked population-based administrative data housed in the Population Research Data Repository at the Manitoba Centre for Health Policy. The cohort consisted of individuals who moved into public housing in 2009 and 2010. We counted the number of hospitalizations, general practitioner (GP) visits, specialist visits, emergency department visits, and prescriptions drugs dispensed in the twelve 30-day intervals (i.e., months) immediately preceding and following the public housing move-in date. Generalized linear models with generalized estimating equations tested for a period (pre/post-move-in) by month interaction. Odds ratios (ORs), incident rate ratios (IRRs), and means are reported along with 95% confidence intervals (95% CIs). Results The cohort included 1942 individuals; the majority were female (73.4%) who lived in low income areas and received government assistance (68.1%). On average, the cohort had more than four health conditions. Over the 24 30-day intervals, the percentage of the cohort that visited a GP, specialist, and an emergency department ranged between 37.0% and 43.0%, 10.0% and 14.0%, and 6.0% and 10.0%, respectively, while the percentage of the cohort hospitalized ranged from 1.0% to 5.0%. Generally, these percentages were highest in the few months before the move-in date and lowest in the few months after the move-in date. The period by month interaction was statistically significant for hospitalizations, GP visits, and prescription drug use. The average change in the odds, rate, or mean was smaller in the post-move-in period than in the pre-move-in period. Conclusions Use of some healthcare services declined after people moved into public housing; however, the decrease was only observed in the first few months and utilization rebounded. Knowledge of healthcare trends before individuals move in are informative for ensuring the appropriate supports are available to new public housing residents. Further study is needed to determine if decreased healthcare utilization following a move is attributable to decreased access. Electronic supplementary material The online version of this article (10.1186/s12913-018-3109-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Aynslie M Hinds
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba, R3E 0W3, Canada.
| | - Brian Bechtel
- Cross Ministry and Community Partnership Initiatives Community and Social Services, 3rd floor, 10044-108 Street, Edmonton, Alberta, T5J 5E6, Canada
| | - Jino Distasio
- Department of Geography, University of Winnipeg, 515 Portage Avenue, Winnipeg, Manitoba, R3B 2E9, Canada
| | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba, R3E 0W3, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, S113-750 Bannatyne Ave, Winnipeg, Manitoba, R3E 0W3, Canada
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Kersten EE, Adler NE, Gottlieb L, Jutte DP, Robinson S, Roundfield K, LeWinn KZ. Neighborhood Child Opportunity and Individual-Level Pediatric Acute Care Use and Diagnoses. Pediatrics 2018; 141:peds.2017-2309. [PMID: 29626164 PMCID: PMC5991499 DOI: 10.1542/peds.2017-2309] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2018] [Indexed: 12/22/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5751513300001PEDS-VA_2017-2309Video Abstract OBJECTIVES: Although health care providers and systems are increasingly interested in patients' nonmedical needs as a means to improve health, little is known about neighborhood conditions that contribute to child health problems. We sought to determine if a novel, publicly available measure of neighborhood context, the Child Opportunity Index, was associated with pediatric acute care visit frequency and diagnoses. METHODS This cross-sectional study included San Francisco residents <18 years of age with an emergency department and/or urgent care visit to any of 3 medical systems (N = 47 175) between 2007 and 2011. Hot-spot analysis was used to compare the spatial distribution of neighborhood child opportunity and income. Generalized estimating equation logistic regression models were used to examine independent associations between neighborhood child opportunity and frequent acute care use (≥4 visits per year) and diagnosis group after adjusting for neighborhood income and patient age, sex, race and/or ethnicity, payer, and health system. RESULTS Neighborhood child opportunity and income had distinct spatial distributions, and we identified different clusters of high- and low-risk neighborhoods. Children living in the lowest opportunity neighborhoods had significantly greater odds of ≥4 acute care visits per year (odds ratio 1.33; 95% confidence interval 1.03-1.73) compared with those in the highest opportunity neighborhoods. Neighborhood child opportunity was negatively associated with visits for respiratory conditions, asthma, assault, and ambulatory care-sensitive conditions but positively associated with injury-related visits. CONCLUSIONS The Child Opportunity Index could be an effective tool for identifying neighborhood factors beyond income related to child health.
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Affiliation(s)
| | - Nancy E. Adler
- Departments of Psychiatry,,Pediatrics, and,Center for Health and Community, University of
California, San Francisco, San Francisco, California
| | - Laura Gottlieb
- Family and Community Medicine, and,Center for Health and Community, University of
California, San Francisco, San Francisco, California
| | - Douglas P. Jutte
- Division of Community Health Sciences, School of
Public Health, University of California, Berkeley, Berkeley, California;,Build Healthy Places Network, San Francisco,
California; and
| | | | | | - Kaja Z. LeWinn
- Departments of Psychiatry,,Center for Health and Community, University of
California, San Francisco, San Francisco, California
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Malecha PW, Williams JH, Kunzler NM, Goldfrank LR, Alter HJ, Doran KM. Material Needs of Emergency Department Patients: A Systematic Review. Acad Emerg Med 2018; 25:330-359. [PMID: 29266523 DOI: 10.1111/acem.13370] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 12/08/2017] [Accepted: 12/12/2017] [Indexed: 12/01/2022]
Abstract
BACKGROUND Interest in social determinants of health (SDOH) has expanded in recent years, driven by a recognition that such factors may influence health outcomes, services use, and health care costs. One subset of SDOH is material needs such as housing and food. We conducted a systematic review of the literature on material needs among emergency department (ED) patients in the United States. METHODS We followed PRISMA guidelines for systematic review methodology. With the assistance of a research librarian, four databases were searched for studies examining material needs among ED patients. Two reviewers independently screened titles, abstracts, and full text to identify eligible articles. Information was abstracted systematically from eligible articles. RESULTS Forty-three articles were eligible for inclusion. There was heterogeneity in study methods; single-center, cross-sectional studies were most common. Specific material needs examined included homelessness, poverty, housing insecurity, housing quality, food insecurity, unemployment, difficulty paying for health care, and difficulty affording basic expenses. Studies overwhelmingly supported the notion that ED patients have a high prevalence of a number of material needs. CONCLUSIONS Despite some limitations in the individual studies examined in this review, the plurality of prior research confirms that the ED serves a vulnerable population with high rates of material needs. Future research is needed to better understand the role these needs play for ED patients and how to best address them.
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Affiliation(s)
| | - James H. Williams
- Department of Emergency Medicine Harbor–UCLA Medical Center TorranceCA
| | - Nathan M. Kunzler
- Brigham and Women's/Massachusetts General Hospital Harvard Affiliated Emergency Medicine Boston MA
| | - Lewis R. Goldfrank
- Ronald O. Perelman Department of Emergency Medicine NYU School of Medicine New York NY
| | - Harrison J. Alter
- Department of Emergency Medicine Highland Hospital–Alameda Health System Oakland CA
| | - Kelly M. Doran
- Ronald O. Perelman Department of Emergency Medicine NYU School of Medicine New York NY
- Department of Population Health NYU School of Medicine New York NY
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Cheng TL, Emmanuel MA, Levy DJ, Jenkins RR. Child Health Disparities: What Can a Clinician Do? Pediatrics 2015; 136:961-8. [PMID: 26459644 PMCID: PMC4621792 DOI: 10.1542/peds.2014-4126] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2015] [Indexed: 12/12/2022] Open
Abstract
Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity.
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Affiliation(s)
- Tina L Cheng
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Department of Population, Family, and Reproductive Health, Bloomberg School of Public Health, Baltimore, Maryland;
| | | | - Daniel J Levy
- Child and Teen Wellness Center, Owings Mill, Maryland; and
| | - Renee R Jenkins
- Department of Pediatrics and Child Health, Howard University, Washington, District of Columbia
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Martinez SM, Thompson-Lastad A. Latino Parents' Insight on Optimal Sleep for Their Preschool-Age Child: Does Context Matter? Acad Pediatr 2015; 15:636-43. [PMID: 26547544 DOI: 10.1016/j.acap.2015.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 07/08/2015] [Accepted: 07/10/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Insufficient sleep is a risk factor for pediatric obesity. Latino children are among those groups in which both short sleep duration and obesity are prevalent. Therefore, this study sought to explore Latino parents' views about ideal sleep duration and sleep-related practices for their preschool-age children in an urban setting. METHODS Between October 2013 and January 2014, Latino parents of 2- to 5-year-old children were interviewed at 3 pediatric clinics (San Francisco, Calif). Using a semistructured interview guide, parents were asked to describe bedtime routines and sleep practices of their preschool-age children, including behavioral, parental, social, and contextual factors that may affect children's sleep. Interviews were conducted in Spanish and English. Parents also completed a brief survey on demographic information. Interviews were analyzed on the basis of a priori and emergent themes. RESULTS Latino parents (n = 18) were mostly female, with a mean age of 31 years; most were foreign born; and more than half had a monthly household income of $2000 or less. The following themes emerged: parents' ideas about optimal sleep duration for their preschool-age child, consistent bedtime routines, room sharing and bed sharing, parent work and child school schedules that affect children's sleep, and crowded housing and neighborhood noise that disrupt children's sleep. CONCLUSIONS These findings increase our understanding of the factors related to achieving optimal sleep duration among Latino children living in urban and often crowded housing. Findings could be used to inform future research on how to increase parental knowledge of healthy sleep practices and adequate sleep among Latino parents of young children.
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Affiliation(s)
- Suzanna M Martinez
- Division of General Pediatrics, School of Medicine, University of California, San Francisco, Calif.
| | - Ariana Thompson-Lastad
- Department of Social and Behavioral Sciences, University of California, San Francisco, Calif
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