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Harmon ME, Fiamingo M, Toler S, Lee K, Kim Y, Martin B, Gilmour I, Farraj AK, Hazari MS. The effect of enriched versus depleted housing on eucalyptus smoke-induced cardiovascular dysfunction in mice. Inhal Toxicol 2024:1-12. [PMID: 38776456 DOI: 10.1080/08958378.2024.2352748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/30/2024] [Indexed: 05/25/2024]
Abstract
Objectives: Living conditions play a major role in health and well-being, particularly for the cardiovascular and pulmonary systems. Depleted housing contributes to impairment and development of disease, but how it impacts body resiliency during exposure to environmental stressors is unknown. This study examined the effect of depleted (DH) versus enriched housing (EH) on cardiopulmonary function and subsequent responses to wildfire smoke. Materials and Methods: Two cohorts of healthy female mice, one of them surgically implanted with radiotelemeters for the measurement of electrocardiogram, body temperature (Tco) and activity, were housed in either DH or EH for 7 weeks. Telemetered mice were exposed for 1 h to filtered air (FA) and then flaming eucalyptus wildfire smoke (WS) while untelemetered mice, which were used for ventilatory assessment and tissue collection, were exposed to either FA or WS. Animals were continuously monitored for 5-7 days after exposure. Results: EH prevented a decrease in Tco after radiotelemetry surgery. EH mice also had significantly higher activity levels and lower heart rate during and after FA and WS. Moreover, EH caused a decreased number of cardiac arrhythmias during WS. WS caused ventilatory depression in DH mice but not EH mice. Housing enrichment also upregulated the expression of cardioprotective genes in the heart. Conclusions: The results of this study indicate that housing conditions impact overall health and cardiopulmonary function. More importantly, depleted housing appears to worsen the response to air pollution. Thus, non-chemical factors should be considered when assessing the susceptibility of populations, especially when it comes to extreme environmental events.
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Affiliation(s)
- Molly E Harmon
- Curriculum in Toxicology and Environmental Medicine, University of NC - Chapel Hill, Chapel Hill, NC, USA
| | - Michelle Fiamingo
- Curriculum in Toxicology and Environmental Medicine, University of NC - Chapel Hill, Chapel Hill, NC, USA
| | - Sydnie Toler
- Gillings School of Global Public Health, University of North Carolina - Chapel Hill, Chapel Hill, NC, USA
| | - Kaleb Lee
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Yongho Kim
- Public Health Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, NC, USA
| | - Brandi Martin
- Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA
| | - Ian Gilmour
- Public Health Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, NC, USA
| | - Aimen K Farraj
- Public Health Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, NC, USA
| | - Mehdi S Hazari
- Public Health Integrated Toxicology Division, Center for Public Health and Environmental Assessment, United States Environmental Protection Agency, NC, USA
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Rahman S, Steeb D. Homeownership Matters: Impact of Homeownership on the Prevalence of Chronic Health Conditions in the United States. Prev Chronic Dis 2024; 21:E33. [PMID: 38753527 PMCID: PMC11155682 DOI: 10.5888/pcd21.230324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
Introduction Homeownership is crucial for stability and healthy life. We examined the role of homeownership in predicting the prevalence of common chronic health conditions in the United States. Methods We used 2020 Behavioral Risk Factor Surveillance System data (N = 401,958) to assess the association between homeownership and self-reported diagnosed diabetes, asthma, cancer, coronary heart disease (CHD), stroke, and kidney disease. We analyzed data by using logistic regression, adjusting for age, sex, race and ethnicity, education, employment, and income and computed odds ratios (ORs) and corresponding 95% CIs. Results Most survey participants (66.8%) owned their residences. Age, marital status, education, and income significantly influenced homeownership. Odds of homeownership progressively increased with age, reaching a peak at 17.45 (95% CI, 16.21-18.79) for adults aged 65 years or older, and non-Hispanic White adults had the highest odds (OR = 3.34; 95% CI, 3.18-3.52). Compared with renters, homeowners generally had lower prevalence of chronic health conditions, especially among those aged 45 to 64 years. After adjusting for age, sex, and race and ethnicity, the odds of having chronic health conditions among renters were higher than those of homeowners: CHD, 1.39 (1.27-1.52); diabetes, 1.27 (1.20-1.35); asthma, 1.29 (1.23-1.36); stroke, 1.89 (1.71-2.09); and kidney disease, 1.59 (1.44-1.77). Conclusion Homeownership can be used to predict the prevalence of several chronic health conditions. Considering its significant influence, public health initiatives should focus on housing-related interventions to improve population health.
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Affiliation(s)
- Shams Rahman
- College of Global Population Health, University of Health Sciences and Pharmacy in St. Louis, 1 Pharmacy Place, St. Louis, MO 63110
| | - David Steeb
- College of Global Population Health, University of Health Sciences and Pharmacy in St. Louis, Missouri
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Mckinney J, Salmanian B, Grace R, Moufarrij S, Sangi-Haghpeykar H, Eppes C, Gandhi M. Social Drivers of COVID-19 Disease Severity in Pregnant Patients. Am J Perinatol 2024; 41:e2269-e2278. [PMID: 37311541 DOI: 10.1055/a-2109-3876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE While coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has had global impact in all populations, certain groups of patients have experienced disproportionate rates of morbidity and mortality. The purpose of this study was to assess the relationship between COVID-19 disease severity, demographic variables, race and ethnicity, and social determinants of health among pregnant patients in a diverse urban population. STUDY DESIGN A retrospective analysis was performed of all pregnant patients diagnosed with COVID-19 at two urban tertiary care centers in Houston, TX between March and August 2020. Maternal demographic, COVID-19 illness criteria, and delivery characteristics were collected. The Centers for Disease Control and Prevention Social Vulnerability Index (SVI) and COVID-19 Community Vulnerability Index (CCVI) were obtained based on a patients' census tract of residence. Analyses compared persons with asymptomatic, mild, or severe-critical disease at diagnosis. RESULTS A total of 317 persons tested positive for COVID-19 during this time period. Asymptomatic persons were more likely to be diagnosed at later gestational ages, but there were no other differences in baseline maternal characteristics. Persons with more severe disease had greater social vulnerability specifically for housing and transportation than those with mild disease (mean SVI [standard error]: 0.72 [0.06] vs. 0.58 [0.2], p = 0.03). Total SVI, total CCVI, and other themed SVI and CCVI indices were not significantly different between groups. CONCLUSION In this cohort of pregnant persons infected with SARS-CoV-2, an association was shown between disease severity and increased vulnerability in living conditions and transportation. Drivers of the pandemic and COVID-19 outcomes are complex and multifactorial, and likely change over time. However, continued efforts to accurately identify and measure social determinants of health in medicine will likely help identify geographic areas and patient populations that are at risk of higher disease burden. This could facilitate preventative and mitigation measures in these areas in future disaster or pandemic situations. KEY POINTS · SVI and CCVI estimate social determinants of health.. · COVID-19 is associated with housing and transportation vulnerability.. · Social determinants contribute to disease burden in pregnancy..
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Affiliation(s)
- Jennifer Mckinney
- Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas
- Department of Obstetrics and Gynecology, Harris Health System, Houston, Texas
| | - Bahram Salmanian
- Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas
| | - Rebecca Grace
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | - Sara Moufarrij
- Department of Obstetrics and Gynecology, Baylor College of Medicine, Houston, Texas
| | | | - Catherine Eppes
- Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas
- Department of Obstetrics and Gynecology, Harris Health System, Houston, Texas
| | - Manisha Gandhi
- Division of Maternal Fetal Medicine, Baylor College of Medicine, Houston, Texas
- Division of Maternal Fetal Medicine, Texas Children's Hospital Pavilion for Women, Houston, Texas
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Kimball S, Reynoso M, McKnight C, Des Jarlais D. Hepatitis C treatment outcomes among people who inject drugs experiencing unstable versus stable housing: Systematic review and meta-analysis. PLoS One 2024; 19:e0302471. [PMID: 38669250 PMCID: PMC11051606 DOI: 10.1371/journal.pone.0302471] [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: 02/15/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The prevalence of hepatitis C virus (HCV) among people who inject drugs (PWID) is between 50-70%. Prior systematic reviews demonstrated that PWID have similar direct acting antiviral treatment outcomes compared to non-PWID; however, reviews have not examined treatment outcomes by housing status. Given the links between housing and health, identifying gaps in HCV treatment can guide future interventions. METHODS We conducted a systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched six databases for articles from 2014 onward. Two reviewers conducted title/abstract screenings, full-text review, and data extraction. We extracted effect measures for treatment initiation, adherence, completion, success, and reinfection by housing status. Studies underwent quality and certainty assessments, and we performed meta-analyses as appropriate. RESULTS Our search yielded 473 studies, eight of which met inclusion criteria. Only the treatment initiation outcome had sufficient measures for meta-analysis. Using a random-effects model, we found those with unstable housing had 0.40 (0.26, 0.62) times the odds of initiating treatment compared to those with stable housing. Other outcomes were not amenable for meta-analysis due to a limited number of studies or differing outcome definitions. CONCLUSIONS Among PWID, unstable housing appears to be a barrier to HCV treatment initiation; however, the existing data is limited for treatment initiation and the other outcomes we examined. There is a need for more informative studies to better understand HCV treatment among those with unstable housing. Specifically, future studies should better define housing status beyond a binary, static measure to capture the nuances and complexity of housing and its subsequent impact on HCV treatment. Additionally, researchers should meaningfully consider whether the outcome(s) of interest are being accurately measured for individuals experiencing unstable housing.
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Affiliation(s)
- Sarah Kimball
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, United States of America
| | - Marley Reynoso
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, United States of America
| | - Courtney McKnight
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, United States of America
- Center for Drug Use and HIV/HCV Research, New York, NY, United States of America
| | - Don Des Jarlais
- Department of Epidemiology, New York University School of Global Public Health, New York, NY, United States of America
- Center for Drug Use and HIV/HCV Research, New York, NY, United States of America
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Barradas S, Lucumi DI, Mentz G, Agudelo DM. A prospective longitudinal approach to examine the association between social position in childhood, adolescence, and adulthood with the control of hypertension during adulthood. Front Public Health 2024; 12:1296593. [PMID: 38680932 PMCID: PMC11045881 DOI: 10.3389/fpubh.2024.1296593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 03/25/2024] [Indexed: 05/01/2024] Open
Abstract
Introduction Hypertension is one of the main concerns in public health, since it is related with increased morbidity, and potential years of life lost in addition to loss of quality of life. This study aimed to assess: (1) the distribution of indicators of life course SEP in a cohort of Colombian patients with hypertension and (2) to assess the association of life course SEP and control of hypertension among this cohort of patients. Methods Data were obtained using the baseline survey of 258 patients from the Social Determinants and Inequities in the Control of Blood Hypertension Program (ProDSICHA). Mother occupation and housing conditions were measured with the Event History Calendar. Mother educational level was measured with the questionnaire developed by the Project on Ethnicity and Race in Latin America (PERLA). Socioeconomic position during adulthood was measured using education, occupation, and income level based in the MacArthur Network. Results The group with a higher lifelong social position and the group of lower lifelong social position showed better control of hypertension (OR = 1.21; p <0.05; OR = 1.33; p < .05, respectively) compared to those whose social position throughout life varied the most. No statistical differences were found in the relations between single lifetime social position variables, and hypertension control in the three time points analyzed. Discussion These findings warrant further research to deeper our understanding on the role of a multidimensional and cumulative approach of social position in hypertension control.
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Affiliation(s)
- Susana Barradas
- School of Social and Human Sciences, Universidad Externado de Colombia, Bogotá, Colombia
| | - Diego I. Lucumi
- Alberto Lleras Camargo School of Government, Universidad de los Andes, Bogotá, Colombia
| | - Graciela Mentz
- Statistician Lead, Anethesiology Department, Medical School, University of Michigan, Ann Arbor, MI, United States
| | - Diana Maria Agudelo
- Psychology Department, School of Social Sciences, Universidad de los Andes, Bogotá, Colombia
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Sharma VK, Mahajon B, Jain AK, Singh R, Rana R, Makhija P, Srikanth N, Dhiman KS. Health and demographic indicators of selected districts of India: An impact of Swasthya Rakshan Programme (SRP). J Public Health Res 2024; 13:22799036241243272. [PMID: 38655097 PMCID: PMC11036932 DOI: 10.1177/22799036241243272] [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: 02/26/2023] [Accepted: 03/14/2024] [Indexed: 04/26/2024] Open
Abstract
Swasthya Rakshan Programme (SRP) provides health care services through Ayurveda, an initiative of the Government of India that aims to survey and create alertness of essential health appliances to ameliorate society from its grassroots level. The present study aimed to survey the prevailing health standards of residents in certain districts of India and to record the prevalence of diseases among them according to their living conditions, food habits, lifestyle, education, occupation and other socio-economic status. Data was collected through a community-based cross-sectional survey conducted from April 2018 to March 2019 in 22 Districts of 19 states in India. A stratified multi-stage sampling design was adopted for the survey. Documentation of demographic profile, food habits, lifestyle, hygiene status, and existing health conditions was assessed. A pre-designed semi-structured questionnaire was used for the collection of the data. Before initiating the programme, written consent was obtained. In this study, from 162 selected villages/colonies/areas, a total of 562,913 population and 81,651 households were surveyed. Sixty-nine thousand three hundred nineteen patients were cared for various ailments through health camps. The study found that the most prevalent disease in the concerned population was 'Sandhivata' (Osteo-arthritis), that is, 43.0%, followed by 'Dourbalya' (Debility), that is, 11.7%. The study includes insightful analyses of comprehensive demographic and health indicators classified by various socio-economic categories. The collected data regarding the prevalence of diseases with their sociodemographic correlations may provide a better understanding of the locality and thus may help in all future health endeavours.
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Affiliation(s)
- Vipin Kumar Sharma
- Regional Ayurveda Research Institute (RARI), Jammu, Jammu and Kashmir, India
| | - Bidhan Mahajon
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
| | - Avinash Kumar Jain
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
| | - Renu Singh
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
| | - Rakesh Rana
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
| | - Pratap Makhija
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
| | - Narayanam Srikanth
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
| | - Kartar Singh Dhiman
- Central Council for Research in Ayurvedic Sciences (CCRAS), New Delhi, Delhi, India
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Parlberg LM, Newman JE, Merhar S, Poindexter B, DeMauro S, Lorch S, Peralta-Carcelen M, Wilson-Costello D, Ambalavanan N, Limperopoulos C, Mack N, Davis JM, Walsh M, Bann CM. Risk factors for food insecurity and association with prenatal care utilization among women who took opioids during pregnancy. RESEARCH SQUARE 2024:rs.3.rs-3921909. [PMID: 38585728 PMCID: PMC10996811 DOI: 10.21203/rs.3.rs-3921909/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Background Food insecurity during pregnancy is associated with poorer outcomes for both mothers and their newborns. Given the ongoing opioid crisis in the United States, mothers who take opioids during pregnancy may be at particular risk of experiencing food insecurity. Methods This research utilized data from 254 biological mothers of infants in the Advancing Clinical Trials in Neonatal Opioid Withdrawal Syndrome (ACT NOW) Outcomes of Babies with Opioid Exposure (OBOE) Study. We examined factors associated with food insecurity among mothers of infants with antenatal opioid exposure and their unexposed (control) counterparts. Chi-square tests and logistic regression were used to compare food insecurity by sociodemographic characteristics, opioid use, prior traumatic experiences, and housing instability. Similar analyses were conducted to examine the relationship between food insecurity during pregnancy and receipt of adequate prenatal care. Results Overall, 58 (23%) of the mothers screened positive for food insecurity. Food insecurity was more common among mothers who took opioids during pregnancy (28% vs. 14%; p =0.007), had public insurance (25% vs. 8%; p = 0.027), had housing instability (28% vs. 11%, p = 0.002), experienced three or more adverse experiences in their childhood (37% vs. 17%; p < 0.001), and reported physical or emotional abuse during their pregnancy (44% vs. 17%; p < 0.001). Mothers with food insecurity during pregnancy were less likely to have received adequate prenatal care (78% vs. 90%; p = 0.020). This difference remained after controlling for demographic characteristics (AOR (95% CI) = 0.39 (0.16, 1.00), p = 0.049). Conclusions This study adds to the body of evidence supporting the need for screening and development of interventions to address food insecurity during pregnancy, particularly among mothers of infants with antenatal opioid exposure, for which limited data are available. The findings revealed that food insecurity frequently co-occurs with housing instability and prior trauma, indicating that a multifaceted intervention incorporating principles of trauma-informed health care is needed. Although those with food insecurity are at increased risk for poor pregnancy outcomes, they were less likely to have received adequate prenatal care despite high levels of public insurance coverage among study participants, suggesting additional strategies are needed to address barriers to health care among this population. Trial registration The Outcomes of Babies with Opioid Exposure (OBOE) Study is registered at Clinical Trials.gov (NCT04149509) (04/11/2019).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Michele Walsh
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
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Lam T, Saso A, Torres Ortiz A, Hatcher J, Woodman M, Chandran S, Thistlethwayte R, Best T, Johnson M, Wagstaffe H, Mai A, Buckland M, Gilmour K, Goldblatt D, Grandjean L. Socioeconomic and Demographic Risk Factors for SARS-CoV-2 Seropositivity Among Healthcare Workers in a UK Hospital: A Prospective Cohort Study. Clin Infect Dis 2024; 78:594-602. [PMID: 37647517 PMCID: PMC10954340 DOI: 10.1093/cid/ciad522] [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: 05/08/2023] [Revised: 07/26/2023] [Accepted: 08/29/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND To protect healthcare workers (HCWs) from the consequences of disease due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the risk factors that drive exposure and infection within hospitals. Insufficient consideration of key socioeconomic variables is a limitation of existing studies that can lead to bias and residual confounding of proposed risk factors for infection. METHODS The Co-STARs study prospectively enrolled 3679 HCWs between April 2020 and September 2020. We used multivariate logistic regression to comprehensively characterize the demographic, occupational, socioeconomic, and environmental risk factors for SARS-CoV-2 seropositivity. RESULTS After adjusting for key confounders, relative household overcrowding (odds ratio [OR], 1.4 [95% confidence interval {CI}, 1.1-1.9]; P = .006), Black, Black British, Caribbean, or African ethnicity (OR, 1.7 [95% CI, 1.2-2.3]; P = .003), increasing age (ages 50-60 years: OR, 1.8 [95% CI, 1.3-2.4]; P < .001), lack of access to sick pay (OR, 1.8 [95% CI, 1.3-2.4]; P < .001). CONCLUSIONS Socioeconomic and demographic factors outside the hospital were the main drivers of infection and exposure to SARS-CoV-2 during the first wave of the pandemic in an urban pediatric referral hospital. Overcrowding and out-of-hospital SARS-CoV-2 contact are less amenable to intervention. However, lack of access to sick pay among externally contracted staff is more easily rectifiable. Our findings suggest that providing easier access to sick pay would lead to a decrease in SARS-CoV-2 transmission and potentially that of other infectious diseases in hospital settings. CLINICAL TRIALS REGISTRATION NCT04380896.
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Affiliation(s)
- Tanya Lam
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
| | - Anja Saso
- Department of Infectious Diseases, Great Ormond Street Hospital, London, United Kingdom
- Department of Tropical and Infectious Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Medical Research Council Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Arturo Torres Ortiz
- Department of Infectious Diseases, Imperial College London, London, United Kingdom
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - James Hatcher
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marc Woodman
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Shruthi Chandran
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | | | - Timothy Best
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - Marina Johnson
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Helen Wagstaffe
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Annabelle Mai
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Matthew Buckland
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - Kimberly Gilmour
- Clinical Immunology, Camelia Botnar Laboratories, Great Ormond Street Hospital, London, United Kingdom
| | - David Goldblatt
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
| | - Louis Grandjean
- Department of Infection, Immunity and Inflammation, Institute of Child Health, University College London, London, United Kingdom
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Manzo LKC, Grove H. Inadequate Social Housing and Health: The Case of Oliver Bond House, The Liberties, Dublin. OPEN RESEARCH EUROPE 2024; 3:211. [PMID: 38384817 PMCID: PMC10879759 DOI: 10.12688/openreseurope.16767.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/26/2024] [Indexed: 02/23/2024]
Abstract
Background Inadequate housing is an important social justice issue that adversely affects health. Methods Drawing on an extended ethnography case study, this paper presents the results of a resident-led survey to highlight the health consequences of inadequate social housing, as residents wait for a 'fair regeneration' of their social housing 'flats' estate within a gentrifying inner-city Dublin neighbourhood. Results Four key concerns were identified by residents as part of this analysis: (1) substandard housing conditions which are physically harmful to health; (2) the emotional toll of an unsafe social environment; (3) lack of child friendly and community green spaces; and (4) constrained mobility due to inaccessible housing design. Conclusions The results highlight the urgent need to place greater priority on the maintenance of the existing social housing stock and demonstrate the need for public housing policies that recognize the quality and quantity of adequate housing provision, where care is at the heart of housing policies. The paper also presents a novel 'City of Care' framework, following the need to develop an ethics of care within cities where public health, community wellbeing, solidarity, residents' empowerment, and social justice principles are at the forefront. Given that housing is an essential contributor to good health, it is now time for a joint public housing and public health agenda to create healthier homes by confronting the everyday impact of inadequate housing to tackle social inequalities more broadly.
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Affiliation(s)
- Lidia Katia C. Manzo
- Languages, Literatures, Cultures and Mediations, University of Milan, Milan, Lombardy, Italy
- Department of Geography and Maynooth University Social Sciences Institute, Maynooth University, Maynooth, Ireland
| | - Hannah Grove
- Global Centre on Healthcare & Urbanisation, Kellogg College, University of Oxford, Oxford, UK
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Link NW, Hyatt JM, Powell K. Public opinion on the expenditure of adult-use cannabis tax revenue: Evidence from New Jersey. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 125:104334. [PMID: 38340482 DOI: 10.1016/j.drugpo.2024.104334] [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: 07/28/2023] [Revised: 01/08/2024] [Accepted: 01/21/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To describe New Jersey residents' relative priorities for the allocation of tax revenue generated by recreational cannabis sales. We aim to assess preferences for public health initiatives, including drug treatment, compared to a range of alternatives, including traditional policing, especially within the social and demographic groupings of people generally most impacted by punitive drug enforcement policies. METHODS We collected population-representative survey data four months post-implementation of recreational cannabis sales in New Jersey (N = 1,006). We gauge respondents' top preferences for the allocation of new revenue generated by the legal cannabis market. Using multinomial logistic regression, we assess how various demographic and political factors shape public support for devoting revenue toward public health initiatives. RESULTS While priorities are mixed within the sample, we find more general support for funding community-based initiatives in public health, housing, and education than for funding police, courts, and prisons. Among Black residents, the largest proportion chose investments in affordable housing. Regression analysis reveals political orientation as having the most consistent association with expressed preferences, with Republicans favoring investments in traditional law enforcement priorities over other potential funding domains. CONCLUSIONS Recreational cannabis legalization is occurring at a rapid pace, yet important context, including how the tax revenue could be invested in communities, remains unclear. Insight into current public opinion on funding priorities suggests a desire for investment in fundamental societal institutions, including education and public health, rather than the punitive enforcement mechanisms that have defined cannabis policy for many decades.
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Affiliation(s)
- Nathan W Link
- Department of Sociology, Anthropology, and Criminal Justice and Health Sciences Center. Rutgers University, Camden, NJ 08102, United States; Center for Public Policy, Drexel University, Philadelphia, PA 19104, United States.
| | - Jordan M Hyatt
- Department of Criminology and Justice Studies, Drexel University, Philadelphia, PA, United States; Center for Public Policy, Drexel University, Philadelphia, PA 19104, United States
| | - Kathleen Powell
- Department of Criminology and Justice Studies, Drexel University, Philadelphia, PA, United States; Center for Public Policy, Drexel University, Philadelphia, PA 19104, United States
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Sullivan A, Armendariz M, Thierry AD. A Scoping Review of Neighborhoods and Cognitive Health Disparities Among US Midlife and Older Adults. J Aging Health 2024; 36:257-270. [PMID: 37350741 DOI: 10.1177/08982643231185379] [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] [Indexed: 06/24/2023]
Abstract
Objectives: The neighborhood environment may be an important determinant of racial/ethnic disparities in cognitive function. To understand how neighborhoods are linked to cognition across racial/ethnic groups, this scoping review organizes research investigating relationships between multiple neighborhood domains and cognitive function in diverse samples of US midlife and older adults. Methods: PubMed/MEDLINE, Web of Science, and CAHL were used to extract quantitative disparities-focused studies (n = 17) that included US adults ages 50+, racial/ethnic minoritized populations, cognitive dependent variable(s), and neighborhood-level independent variable(s) published from January 2010 to October 2021. Results: Studies demonstrate variation within and between racial/ethnic groups in how neighborhood factors are associated with cognition. Economically and socially advantaged neighborhoods were associated with better cognition. Findings were mixed for built and neighborhood composition measures. Discussion: More research with greater racial/ethnic representation is needed to disentangle which aspects of the neighborhood are most salient for specific cognitive function domains across diverse populations.
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Affiliation(s)
- Allison Sullivan
- Department of Public Health, Jackson State University, Jackson, MS, USA
| | - Marina Armendariz
- Department of Public Health, University of Texas at San Antonio, San Antonio, TX, USA
| | - Amy D Thierry
- Department of Public Health Sciences, Xavier University of Louisiana, New Orleans, LA, USA
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Robb K, Ahmed R, Wong J, Ladd E, de Jong J. Substandard housing and the risk of COVID-19 infection and disease severity: A retrospective cohort study. SSM Popul Health 2024; 25:101629. [PMID: 38384433 PMCID: PMC10879830 DOI: 10.1016/j.ssmph.2024.101629] [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: 12/12/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/23/2024] Open
Abstract
In this study we examine associations between substandard housing and the risk of COVID-19 infection and severity during the first year of the pandemic by linking individual-level housing and clinical datasets. Residents of Chelsea, Massachusetts who were tested for COVID-19 at any Mass General Brigham testing site and who lived at a property that had received a city housing inspection were included (N = 2873). Chelsea is a densely populated city with a high prevalence of substandard housing. Inspected properties with housing code violations were considered substandard; inspected properties without violations were considered adequate. COVID-19 infection was defined as any positive PCR test, and severe disease defined as hospitalization with COVID-19. We used a propensity score design to match individuals on variables including age, race, sex, and income. In the severity model, we also matched on ten comorbidities. We estimated the risk of COVID-19 infection and severity associated with substandard housing using Cox Proportional Hazards models for lockdown, the first phase of reopening, and the full study period. In our sample, 32% (919/2873) of individuals tested positive for COVID-19 and 5.9% (135/2297) had severe disease. During lockdown, substandard housing was associated with a 48% increased risk of COVID-19 infection (95%CI 1.1-2.0, p = 0.006). Through Phase 1 reopening, substandard housing was associated with a 39% increased infection risk (95%CI 1.1-1.8, p = 0.020). The difference in risk attenuated over the full study period. There was no difference in severe disease risk between the two groups. The increased risk, observed only during lockdown and early reopening - when residents were most exposed to their housing - strengthens claims that substandard housing conveys higher infection risk. The results demonstrate the value of combining cross-sector datasets. Existing city housing data can be leveraged 1) to identify and prioritize high-risk areas for future pandemic response, and 2) for longer-term housing solutions.
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Affiliation(s)
- Katharine Robb
- Bloomberg Center for Cities, Harvard Kennedy School, Cambridge, MA, USA
| | - Rowana Ahmed
- Bloomberg Center for Cities, Harvard Kennedy School, Cambridge, MA, USA
| | - John Wong
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - Elissa Ladd
- School of Nursing, MGH Institute of Health Professions, Boston, MA, USA
| | - Jorrit de Jong
- Bloomberg Center for Cities, Harvard Kennedy School, Cambridge, MA, USA
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13
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Tura BR, da Costa MR, Lordello S, Barros D, Souza Y, da Silva Santos M. Health inequity assessment in Brazil: is EQ-5D-3L sensible enough to detect differences among distinct socioeconomic groups? Health Qual Life Outcomes 2024; 22:22. [PMID: 38409033 PMCID: PMC10898160 DOI: 10.1186/s12955-024-02235-0] [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: 09/21/2023] [Accepted: 02/07/2024] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND Multidimensional health-related quality of life (HRQOL) instruments, such as the EQ-5D, are increasingly used to assess inequalities in health. However, it is necessary to explore the ability of these instruments to capture differences between population groups, especially in low/middle-income countries. This study aimed to investigate whether the EQ-5D-3L instrument can detect differences in HRQOL between groups of different socioeconomic status (SES) in Brazil. METHODS Data collection occurred during the Brazilian EQ-5D-3L valuation study and included respondents aged 18 to 64 years enrolled in urban areas. SES was aggregated into three categories: "higher" (A and B), "intermediate" (C) and "lower" (D and E). EQ-5D-3L index was calculated considering the Brazilian value set. A mixed-effects regression model was estimated with random effects on individuals and marginal effects on SES, sex, and educational attainment. Odds ratios for the chance of reporting problems for each EQ-5D dimension were estimated by logistic regression. RESULTS A total of 9,148 respondents were included in the study. Mean age was 37.80 ± 13.13 years, 47.4% were men and the majority was ranked as classes B or C (38.4% and 50.7%, respectively). Participants in lower SES classes reported increasingly poorer health compared to individuals in higher classes. The mean EQ-5D-3L index decreased as SES deteriorates being significantly higher for classes A and B (0.874 ± 0.14) compared to class C (0.842 ± 0.15) and classes D and E (0.804 ± 0.17) (p < 0.001). The same was observed for the mean EQ-VAS scores (84.0 ± 13.8 in classes A and B, 81.0 ± 17 in class C and 78.3 ± 18.7 in class C [p < 0.001]). The multivariate analysis confirmed that SES is an independent factor that effects EQ-5D-3L index measures. Participants in intermediate and lower SES classes have a statistically significant lower EQ-5D-3L index compared to participants in classes A and B, regardless of age, sex, and educational attainment. CONCLUSION In a Brazilian population sample, the EQ-5D-3L instrument was able to detect important differences between groups with distinct socioeconomic statuses (SES). The EQ-5D-3L is useful for exploring inequities in health.
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Affiliation(s)
- Bernardo Rangel Tura
- Centre of Health Technology Assessment, National Institute of Cardiology, Rio de Janeiro, Brazil
| | - Milene Rangel da Costa
- Centre of Health Technology Assessment, National Institute of Cardiology, Rio de Janeiro, Brazil
- Faculty of Pharmacy, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Marisa da Silva Santos
- Centre of Health Technology Assessment, National Institute of Cardiology, Rio de Janeiro, Brazil.
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14
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Scott N, Atatoa Carr PE, Jones AR, Sandiford P, Masters-Awatere B, Clark H. Harti Hauora Tamariki: randomised controlled trial protocol for an opportunistic, holistic and family centred approach to improving outcomes for hospitalised children and their families in Aotearoa, New Zealand. Front Pediatr 2024; 12:1359214. [PMID: 38455391 PMCID: PMC10917950 DOI: 10.3389/fped.2024.1359214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 02/12/2024] [Indexed: 03/09/2024] Open
Abstract
Background Health and wellbeing inequities between the Indigenous Māori and non-Māori populations in Aotearoa, New Zealand continue to be unresolved. Within this context, and of particular concern, hospitalisations for diseases of poverty are increasing for tamariki Māori (Māori children). To provide hospitalised tamariki Māori, and their whānau (families) comprehensive support, a wellbeing needs assessment; the Harti Hauora Tamariki Tool (The Harti tool) was developed. The purpose of this study is to determine how effective the Harti tool is at identifying wellbeing needs, ensuring the documentation of needs, enabling access to services and improving wellbeing outcomes for tamariki and their whānau. Methods The study uses a Kaupapa Māori methodology with qualitative and quantitative methods. Qualitative methods include in-depth interviews with whānau. This paper presents an overview of a randomised, two parallel, controlled, single blinded, superiority trial for quantitative evaluation of the Harti programme, and hospital satisfaction with care survey. Participants will be Māori and non-Māori tamariki/children aged 0-4 years admitted acutely to the paediatric medical wards at Waikato Hospital, Hamilton, Aotearoa New Zealand. They will be randomised electronically into the intervention or usual care group. The intervention group will receive usual care in addition to the Harti programme, which includes a 24-section health needs assessment delivered by trained Māori navigators to whānau during the time they are in hospital. The primary endpoint is the relative risk of an acute hospital readmission in the 30 days following discharge for the intervention group patients compared with control group patients. Secondary outcomes include access and utilisation of preventative health services including: oral health care, general practice enrolment, immunisation, healthy home initiatives, smoking cessation and the Well Child Tamariki Ora universal health checks available free of charge for children in Aotearoa New Zealand. Discussion Randomised controlled trials are a gold standard for measuring efficacy of complex multifaceted interventions and the results will provide high quality evidence for implementing the intervention nationwide. We expect that this study will provide valuable evidence for health services and policy makers who are considering how to improve the configuration of paediatric hospital services. Trial registration The study is registered with the Australian New Zealand Clinical Trials Registry (ANZCTR), registration number: ACTRN12618001079235.
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Affiliation(s)
- Nina Scott
- Matauranga Māori, Rangahau Hauora Māori, Te Aka Whai Ora, Hamilton, New Zealand
| | - Polly E. Atatoa Carr
- Te Whatu Ora Waikato, Hamilton, New Zealand
- Te Ngira, Institute for Population Research, University of Waikato, Hamilton, New Zealand
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15
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Antin TM, Sanders E, Lipperman-Kreda S, Hunt G, Annechino R. An Exploration of Rural Housing Insecurity as a Public Health Problem in California's Rural Northern Counties. J Community Health 2024:10.1007/s10900-024-01330-z. [PMID: 38372874 DOI: 10.1007/s10900-024-01330-z] [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] [Accepted: 01/25/2024] [Indexed: 02/20/2024]
Abstract
Although widely acknowledged as an important social determinant of health, until recently researchers and policymakers have primarily approached housing insecurity as an urban issue, obscuring the visibility of its impacts in rural contexts, including the ways in which housing insecurity intersects with other health and structural inequities facing rural populations. Working to address this gap in the existing literature, this paper explores the experiences of housing insecurity in a rural context by reporting on an analysis of 210 in-depth interviews with 153 adults between the ages of 18-35, living in California's rural North State, a relatively overlooked far northern region of the state comprised of 12 north central and north eastern counties. Using in-depth qualitative interview data, we conducted an exploratory pattern-level analysis of participants' narratives structured by four dimensions of housing insecurity defined in the literature (housing affordability, housing stability, housing conditions, and neighborhood context). Drawing attention to the pervasiveness of rural housing insecurity within our sample, this analysis highlights the unique ways in which rurality creates distinct experiences not currently captured in the existing literature. Further research is needed across different types of rural communities to better understand the various ways that housing insecurity affects the everyday lives and health of rural residents. By grounding research within the experiences of rural residents, we are better able to respond to the crisis of rural housing insecurity and develop solutions that are tailored to rural residents' unique needs.
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Affiliation(s)
- Tamar Mj Antin
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, CA, 94501, USA.
| | - Emile Sanders
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, CA, 94501, USA
| | - Sharon Lipperman-Kreda
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, CA, 94501, USA
| | - Geoffrey Hunt
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, CA, 94501, USA
| | - Rachelle Annechino
- Center for Critical Public Health, Institute for Scientific Analysis, Alameda, CA, 94501, USA
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16
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Springer YP, Kammerer JS, Felix D, Newell K, Tompkins ML, Allison J, Castrodale LJ, Chandler B, Helfrich K, Rothoff M, McLaughlin JB, Silk BJ. Using Geographic Disaggregation to Compare Tuberculosis Epidemiology Among American Indian and Alaska Native Persons-USA, 2010-2020. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-01919-z. [PMID: 38334874 DOI: 10.1007/s40615-024-01919-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/29/2023] [Accepted: 01/20/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND American Indian and Alaska Native (AIAN) populations are frequently associated with the highest rates of tuberculosis (TB) disease of any racial/ethnic group in the USA. We systematically investigated variation in patterns and potential drivers of TB epidemiology among geographically distinct AIAN subgroups. METHODS Using data reported to the National Tuberculosis Surveillance System during 2010-2020, we applied a geographic method of data disaggregation to compare annual TB incidence and the frequency of TB patient characteristics among AIAN persons in Alaska with AIAN persons in other states. We used US Census data to compare the prevalence of substandard housing conditions in AIAN communities in these two geographic areas. RESULTS The average annual age-adjusted TB incidence among AIAN persons in Alaska was 21 times higher than among AIAN persons in other states. Compared to AIAN TB patients in other states, AIAN TB patients in Alaska were associated with significantly higher frequencies of multiple epidemiologic TB risk factors (e.g., attribution of TB disease to recent transmission, previous diagnosis of TB disease) and significantly lower frequencies of multiple clinical risk factors for TB disease (e.g., diagnosis with diabetes mellitus, end-stage renal disease). Occupied housing units in AIAN communities in Alaska were associated with significantly higher frequencies of multiple measures of substandard housing conditions compared to AIAN communities in other states. CONCLUSIONS Observed differences in patient characteristics and substandard housing conditions are consistent with contrasting syndromes of TB epidemiology in geographically distinct AIAN subgroups and suggest ways that associated public health interventions could be tailored to improve efficacy.
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Affiliation(s)
- Yuri P Springer
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA, USA.
| | - J Steve Kammerer
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA, USA
| | - Derrick Felix
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA, USA
| | - Katherine Newell
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, Division of Workforce Development, Atlanta, GA, USA
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Megan L Tompkins
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Jamie Allison
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Louisa J Castrodale
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Bruce Chandler
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Kathryn Helfrich
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Michelle Rothoff
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Joseph B McLaughlin
- Alaska Division of Public Health, Section of Epidemiology, Anchorage, Alaska, USA
| | - Benjamin J Silk
- Centers for Disease Control and Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Atlanta, GA, USA
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Ziafati Bafarasat A, Sharifi A. How to Achieve a Healthy City: a Scoping Review with Ten City Examples. J Urban Health 2024; 101:120-140. [PMID: 38110772 PMCID: PMC10897125 DOI: 10.1007/s11524-023-00798-9] [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] [Accepted: 09/28/2023] [Indexed: 12/20/2023]
Abstract
This scoping review of the literature explores the following question: what systematic measures are needed to achieve a healthy city? The World Health Organization (WHO) suggests 11 characteristics of a healthy city. Measures contributing to these characteristics are extracted and classified into 29 themes. Implementation of some of these measures is illustrated by examples from Freiburg, Greater Vancouver, Singapore, Seattle, New York City, London, Nantes, Exeter, Copenhagen, and Washington, DC. The identified measures and examples indicate that a healthy city is a system of healthy sectors. A discussion section suggests healthy directions for nine sectors in a healthy city. These sectors include transportation, housing, schools, city planning, local government, environmental management, retail, heritage, and healthcare. Future work is advised to put more focus on characteristic 5 (i.e., the meeting of basic needs for all the city's people) and characteristic 10 (i.e., public health and sick care services accessible to all) of a healthy city.
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Affiliation(s)
| | - Ayyoob Sharifi
- The IDEC Institute & Network for Education and Research On Peace and Sustainability (NERPS), Hiroshima University, Higashi-Hiroshima, Japan
- School of Architecture and Design, Lebanese American University, Beirut, Lebanon
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18
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Chakraborty O, Dragan KL, Ellen IG, Glied SA, Howland RE, Neill DB, Wang S. Housing-Sensitive Health Conditions Can Predict Poor-Quality Housing. Health Aff (Millwood) 2024; 43:297-304. [PMID: 38315928 DOI: 10.1377/hlthaff.2023.01008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Improving housing quality may improve residents' health, but identifying buildings in poor repair is challenging. We developed a method to improve health-related building inspection targeting. Linking New York City Medicaid claims data to Landlord Watchlist data, we used machine learning to identify housing-sensitive health conditions correlated with a building's presence on the Watchlist. We identified twenty-three specific housing-sensitive health conditions in five broad categories consistent with the existing literature on housing and health. We used these results to generate a housing health index from building-level claims data that can be used to rank buildings by the likelihood that their poor quality is affecting residents' health. We found that buildings in the highest decile of the housing health index (controlling for building size, community district, and subsidization status) scored worse across a variety of housing quality indicators, validating our approach. We discuss how the housing health index could be used by local governments to target building inspections with a focus on improving health.
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Affiliation(s)
| | - Kacie L Dragan
- Kacie L. Dragan, Harvard University, Cambridge, Massachusetts
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19
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Van den Broeck K, Bielen L, Maelstaf H, Van Roy K, Versele A. Well-being Effects of a Subsidy Retention Fund for Renovation of Dwellings of Locked-in Owners in Ghent. J Urban Health 2024; 101:170-180. [PMID: 38347275 PMCID: PMC10897071 DOI: 10.1007/s11524-023-00793-0] [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] [Accepted: 09/13/2023] [Indexed: 02/28/2024]
Abstract
With its subsidy retention fund, the city of Ghent targets homeowners, who live in a dwelling of bad quality and do not have the resources to renovate or move out. Being in this no-choice situation, they are locked-in homeowners. Through this innovative policy instrument, Ghent aims to improve the quality of its housing stock targeting households who may not take up other renovation-encouraging instruments. To reach the households who would otherwise not be able to renovate, important efforts in outreaching and offering technical and social guidance accompany the renovation subsidy. Guidance activities substantially increase the cost of the instrument, but in reaching the households living in bad-quality houses, it has the potential to create major benefits not only technically but also socially as housing quality is related to well-being. Generally, the identification of a causal relationship is difficult as well-being and its mediators are complex matters. This case offered a unique opportunity to collect information from the beneficiaries on a range of well-being domains both before the renovation of their dwelling and after the renovation. Even though the research was restricted to short-term effects, the results suggest that improvements in different domains of well-being can be linked to the improvement of housing quality. These improvements in well-being in Ghent show that (local) government spending in housing renovation of locked-in homeowners can be an instrument to achieve social progress.
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Affiliation(s)
| | - Leontien Bielen
- Faculty of Engineering Technology, Building Physics & Sustainable Design, KU Leuven, Technology Campus Ghent, Ghent, Belgium
| | - Hilde Maelstaf
- Department of Health and Well-Being, Artesis Plantijn Hogeschool Antwerpen, Noorderplaats 2, 2000, Antwerp, Belgium
| | - Kaatje Van Roy
- Faculty of Medicine and Health Sciences, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Alexis Versele
- Faculty of Engineering Technology, Building Physics & Sustainable Design, KU Leuven, Technology Campus Ghent, Ghent, Belgium
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Michaelson V, King N, Šmigelskas K, Dackevičienė AS, Malinowska-Cieślik M, Patte K, Gardner P, Inchley J, Pickett W. Establishing spirituality as an intermediary determinant of health among 42,843 children from eight countries. Prev Med 2024; 179:107846. [PMID: 38181895 DOI: 10.1016/j.ypmed.2024.107846] [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: 05/27/2023] [Revised: 12/19/2023] [Accepted: 01/02/2024] [Indexed: 01/07/2024]
Abstract
The World Health Organization (WHO) Commission on the Social Determinants of Health (CSDH) conceptual framework identifies socio-economic position as a structural determinant of health. Recognized intermediary determinants include biological, behavioural, and psychosocial factors. We examined whether connections afforded by a healthy spirituality potentially act as unrecognized intermediary determinants in adolescent populations, contributing to inequities in mental health. Reports from 42,843 children (21,007 boys, 21,836 girls) from eight countries who participated in the 2017-2018 Health Behaviour in School-aged Children (HBSC) study were used to describe correlations between family affluence and positive levels of mental health, using a cross-sectional design. Based on the CSDH conceptual framework and multivariable regression analyses, we then examined whether these associations were mediated by spiritual health. Connections afforded by a high level of spiritual health were universally correlated with positive mental health status. In three Western European nations (England, Scotland, and Wales) and Canada affluence was correlated with better mental health and this was partially mediated by spiritual health. Among the four Eastern European countries (Latvia, Lithuania, Moldova, Poland), our findings did not support aspects of the CSDH framework that focus on affluence as a direct determinant of health. Spiritual health potentially is an intermediary determinant of children's health in some Western countries, but not in Eastern countries. The universality of social determinants of health models and the measures used in their evaluation require careful assessment across cultures, political contexts, and health outcomes.
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Affiliation(s)
- Valerie Michaelson
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, Canada.
| | - Nathan King
- Department of Public Health Sciences, Queen's University, Carruthers Hall, 62 Fifth Field Company Lane, Kingston, Ontario, Canada
| | - Kastytis Šmigelskas
- Health Research Institute, Faculty of Publich Health, Medical Academy, Lithuanian University of Health Sciences, Tilžės g. 18, Kaunas LT-47181, Lithuania
| | - Agnė Slapšinskaitė Dackevičienė
- Health Research Institute, Faculty of Publich Health, Medical Academy, Lithuanian University of Health Sciences, Tilžės g. 18, Kaunas LT-47181, Lithuania
| | - Marta Malinowska-Cieślik
- Department of Environmental Health, Faculty of Health Sciences, Jagiellonian University, Medical College, Skawińska Street 8, 31-066 Kraków, Poland
| | - Karen Patte
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, Canada
| | - Pauli Gardner
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, Canada
| | - Jo Inchley
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, Glasgow, UK
| | - William Pickett
- Department of Health Sciences, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, Ontario, Canada; Department of Public Health Sciences, Queen's University, Carruthers Hall, 62 Fifth Field Company Lane, Kingston, Ontario, Canada
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Bunker A, Compoaré G, Sewe MO, Laurent JGC, Zabré P, Boudo V, Ouédraogo WA, Ouermi L, Jackson ST, Arisco N, Vijayakumar G, Yildirim FB, Barteit S, Maggioni MA, Woodward A, Buonocore JJ, Regassa MD, Brück T, Sié A, Bärnighausen T. The effects of cool roofs on health, environmental, and economic outcomes in rural Africa: study protocol for a community-based cluster randomized controlled trial. Trials 2024; 25:59. [PMID: 38229177 PMCID: PMC10792891 DOI: 10.1186/s13063-023-07804-0] [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: 08/15/2023] [Accepted: 11/16/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND High ambient air temperatures in Africa pose significant health and behavioral challenges in populations with limited access to cooling adaptations. The built environment can exacerbate heat exposure, making passive home cooling adaptations a potential method for protecting occupants against indoor heat exposure. METHODS We are conducting a 2-year community-based stratified cluster randomized controlled trial (cRCT) implementing sunlight-reflecting roof coatings, known as "cool roofs," as a climate change adaptation intervention for passive indoor home cooling. Our primary research objective is to investigate the effects of cool roofs on health, indoor climate, economic, and behavioral outcomes in rural Burkina Faso. This cRCT is nested in the Nouna Health and Demographic Surveillance System (HDSS), a population-based dynamic cohort study of all people living in a geographically contiguous area covering 59 villages, 14305 households and 28610 individuals. We recruited 1200 participants, one woman and one man, each in 600 households in 25 villages in the Nouna HDSS. We stratified our sample by (i) village and (ii) two prevalent roof types in this area of Burkina Faso: mud brick and tin. We randomized the same number of people (12) and homes (6) in each stratum 1:1 to receiving vs. not receiving the cool roof. We are collecting outcome data on one primary endpoint - heart rate, (a measure of heat stress) and 22 secondary outcomes encompassing indoor climate parameters, blood pressure, body temperature, heat-related outcomes, blood glucose, sleep, cognition, mental health, health facility utilization, economic and productivity outcomes, mosquito count, life satisfaction, gender-based violence, and food consumption. We followed all participants for 2 years, conducting monthly home visits to collect objective and subjective outcomes. Approximately 12% of participants (n = 152) used smartwatches to continuously measure endpoints including heart rate, sleep and activity. DISCUSSION Our study demonstrates the potential of large-scale cRCTs to evaluate novel climate change adaptation interventions and provide evidence supporting investments in heat resilience in sub-Saharan Africa. By conducting this research, we will contribute to better policies and interventions to help climate-vulnerable populations ward off the detrimental effects of extreme indoor heat on health. TRIAL REGISTRATION German Clinical Trials Register (DRKS) DRKS00023207. Registered on April 19, 2021.
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Affiliation(s)
- Aditi Bunker
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
| | | | - Maquins Odhiambo Sewe
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Public Health and Clinical Medicine, Sustainable Health Section, Umeå University, Umeå, Sweden
| | - Jose Guillermo Cedeno Laurent
- Environmental Health and Occupational Health Sciences Institute, School of Public Health, Rutgers University, Rutgers, USA
| | - Pascal Zabré
- Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
| | - Valentin Boudo
- Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
| | | | - Lucienne Ouermi
- Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
| | - Susan T Jackson
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Nicholas Arisco
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Govind Vijayakumar
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Ferhat Baran Yildirim
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
| | - Martina Anna Maggioni
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments, Berlin, Germany
- Department of Biomedical Sciences for Health, Università Degli Studi Di Milano, Milan, Italy
| | - Alistair Woodward
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jonathan J Buonocore
- Department of Environmental Health, Boston University School of Public Health, Boston, USA
| | | | - Tilman Brück
- Leibniz Institute of Vegetable and Ornamental Crops (IGZ), Großbeeren, Germany
- Thaer-Institute, Humboldt-University of Berlin, Berlin, Germany
- International Security and Development Center (ISDC), Berlin, Germany
| | - Ali Sié
- Centre de Recherche en Santé de Nouna (CRSN), Nouna, Burkina Faso
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
- Africa Health Research Institute (AHRI), KwaZulu-Natal, South Africa
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Islam M, Islam K, Dalal K, Hossain Hawlader MD. In-house environmental factors and childhood acute respiratory infections in under-five children: a hospital-based matched case-control study in Bangladesh. BMC Pediatr 2024; 24:38. [PMID: 38216932 PMCID: PMC10787469 DOI: 10.1186/s12887-024-04525-4] [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: 03/28/2023] [Accepted: 01/01/2024] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Acute respiratory infection (ARI) is one of the leading causes of morbidity and mortality among children under five globally, particularly in regions like South Asia and sub-Saharan Africa. Bangladesh has made substantial progress in reducing child mortality, yet pneumonia remains a significant contributor to under-five deaths. This study aimed to investigate the association between in-house environmental factors and childhood ARI, considering factors such as household crowding, smoking, and sanitation facilities. METHODS This case-control study was conducted at a tertiary-level children's hospital in Dhaka, Bangladesh, from March to September 2019. The study included children aged 6-59 months. Cases were children with ARI symptoms, while controls were children without such symptoms. Rigorous matching by age and gender was employed to ensure comparability. Data were collected through structured questionnaires, and bivariate and conditional logistic regression analyses were performed. RESULTS Several household environmental factors were significantly associated with childhood ARIs. Children from overcrowded households (AOR = 2.66, 95% CI = 1.52-4.71; p < 0.001), those using unclean cooking fuels (OR = 2.41, 95% CI: 1.56, 3.73; p = < 0.001), those exposed to in-house smoking (AOR = 1.74, 95% CI = 1.01, 3.05; p = 0.04) and those with unimproved sanitation facilities faced higher odds (AOR = 4.35, 95% CI = 2.14-9.26) of ARIs. Additionally, preterm birth and higher birth order were associated with an increased risk of ARI. In contrast, exclusive breastfeeding was a protective factor. CONCLUSION In-house environmental factors, including sanitation, crowding and in-house smoking, significantly influence childhood ARIs. Additionally, birth order and preterm birth play a crucial role. Promoting exclusive breastfeeding is associated with a lower ARI risk among under-five children in Bangladesh. These findings can guide interventions to reduce ARIs in low-income regions, particularly in South Asia.
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Affiliation(s)
- Moktarul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Kariul Islam
- Department of Public Health, North South University, Dhaka, 1229, Bangladesh
| | - Koustuv Dalal
- School of Health Sciences, Division of Public Health Science, Mid Sweden University, Sundsvall, 851 70, Sweden.
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Sevik I, Ciceklioglu M. Healthcare Access Worsened for Women in Precarious Housing During the COVID-19 Pandemic: A Qualitative Study. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241246478. [PMID: 38602064 PMCID: PMC11008088 DOI: 10.1177/00469580241246478] [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: 11/17/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/12/2024]
Abstract
This research aims to gain an in-depth understanding of precariously housed women's experiences related to health and access to health care during the COVID-19 pandemic using a grounded theory approach. Qualitative data were obtained through interviews with 17 precariously housed women from Izmir, Turkey. Poor health among most participants was primarily attributed to unfavorable living conditions and weakened community networks. The COVID-19 pandemic exacerbated existing health issues due to barriers in accessing basic needs. Food insecurity was widespread during the pandemic and the critical role of aid and the inadequacy of social assistance in securing food were emphasized. Women's health perceptions were significantly shaped by gender, and gendered caregiving duties have restricted women's healthcare access. Access to healthcare was also limited by financial challenges, with health insurance being a crucial determinant. Longer waiting times, often exacerbated by the appointment system, and language were significant barriers to healthcare access. The findings propose that the participants were precarized by the blindness of COVID-19 measures to vulnerabilities, which resulted in deeper inequalities in housing, food, employment, and healthcare access. This research addresses the political, commercial, and social determinants of precariously housed women's health. Improving precariously housed women's health and wellbeing requires implementation of public policies targeting to improve housing quality, provide targeted assistance to food insecurity, promote gender inclusiveness, and foster gender empowerment.
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Affiliation(s)
- Irem Sevik
- Department of Public Health, Ege University Medical Faculty, Izmir, Turkey
| | - Meltem Ciceklioglu
- Department of Public Health, Ege University Medical Faculty, Izmir, Turkey
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24
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Groot J, Nielsen ET, Nielsen TF, Andersen PK, Pedersen M, Sigsgaard T, Loft S, Nybo Andersen AM, Keller A. Exposure to residential mold and dampness and the associations with respiratory tract infections and symptoms thereof in children in high income countries: A systematic review and meta-analyses of epidemiological studies. Paediatr Respir Rev 2023; 48:47-64. [PMID: 37482434 DOI: 10.1016/j.prrv.2023.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/08/2023] [Indexed: 07/25/2023]
Abstract
BACKGROUND Multiple reviews have been conducted on the associations between residential mold and dampness and respiratory outcomes in children, with few specifically investigating respiratory tract infections (RTIs). OBJECTIVE We aimed to review and synthesize the available epidemiological literature on mold and dampness and risk of RTIs and respiratory symptoms compatible with RTIs in children living in high-income countries. METHOD We performed a systematic search of literature available from MEDLINE, Embase, and Web of Science for observational studies. We conducted meta-analyses using two-level random effects (RE) and multi-level random effects (ML) models for contrasts of three exposure and three outcome categories, including multiple estimates reported by single studies. We report central estimates for pooled odds ratios (OR) and 95 % confidence intervals (CI).We conducted a risk of bias assessment using the Joanna Briggs Initiative (JBI) checklists for cross-sectional, case-control, and cohort studies. We additionally report on cumulative meta-analyses, leave-one-out analyses of single estimates, subgroup analyses by study quality and study design and inclusion of all effect estimates. RESULTS Of the 932 studies initially screened by title and abstract, we included 30 studies with 267 effect estimates that met the inclusion criteria. Most were cross-sectional (n = 22), with fewer cohort (n = 5) and case-control (n = 3) studies. Most of the studies were according to the bias assessment of poor or fair quality (n = 24). The main meta-analyses generally provided similar results regardless of statistical model and central estimates ranged from OR 1.28 (95 % CI; 1.08, 1.53) for dampness and RTIs to OR 1.76 (95 % CI; 1.64, 1.88) for mold and respiratory symptoms. Most analyses were of moderate heterogeneity. Funnel plots did not indicate strong publication bias. CONCLUSION Our results are compatible with a weak to moderate effect of residential mold and or dampness on risk of RTIs in children in high-income countries. However, these results are based primarily on cross-sectional studies.
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Affiliation(s)
- Jonathan Groot
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Emilie Tange Nielsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Trine Fuhr Nielsen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Per Kragh Andersen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Marie Pedersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Torben Sigsgaard
- Environment, Work and Health, Department of Public Health, University of Aarhus, Aarhus, Denmark
| | - Steffen Loft
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne-Marie Nybo Andersen
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Amélie Keller
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Abramovich A, Gould WA, Pang N, de Oliveira C, Iwajomo T, Vigny-Pau M, MacKinnon K, Lam JSH, Kurdyak P. Exploring Mediators of Mental Health Service Use Among Transgender Individuals in Ontario, Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:933-948. [PMID: 37165522 PMCID: PMC10657585 DOI: 10.1177/07067437231171541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVES To determine if and to what degree neighbourhood-level marginalization mediates mental health service use among transgender individuals. METHODS This retrospective cohort study identified 2,085 transgender individuals through data obtained from 4 outpatient community and hospital clinics in 3 large cities in Ontario, which were linked with administrative health data between January 2015 and December 2019. An age-matched 1:5 comparison cohort was created from the general population of Ontario. Outcome measures were analysed from March 2020 to May 2022. The primary outcome was mental health service utilization, which included mental health-related visits to primary care providers, psychiatrists, mental health- and self-harm-related emergency department visits, and mental health hospitalizations. Mediation variables included ethnic concentration, residential instability, dependency, and material deprivation at the neighbourhood level and were derived from the Ontario Marginalization Index. RESULTS This study identified 2,085 transgender individuals from participating outpatient community and hospital clinics, who were matched to the general population (n = 10,425). Overall, neighbourhood-level marginalization did not clinically mediate mental health service use. However, transgender individuals were more likely to be exposed to all forms of neighbourhood-level marginalization, as well as having higher rates of health service use across all outcome measures. CONCLUSIONS In this study, mental health service use among transgender individuals was not clinically mediated by marginalization at the neighbourhood level. This study highlights the need to explore marginalization and mental health service use at the individual level to better understand the mental health disparities experienced by transgender individuals and to ensure that health-care services are inclusive and affirming.
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Affiliation(s)
- Alex Abramovich
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - W. Ariel Gould
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Nelson Pang
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Claire de Oliveira
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada
- ICES University of Toronto, Mental Health and Addictions Research Program, Toronto, Canada
- Centre for Health Economics and Hull York Medical School, University of York, York, UK
| | - Tomisin Iwajomo
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- ICES University of Toronto, Mental Health and Addictions Research Program, Toronto, Canada
| | - Myriam Vigny-Pau
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
| | | | - June Sing Hong Lam
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- ICES University of Toronto, Mental Health and Addictions Research Program, Toronto, Canada
- General and Health Systems Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
| | - Paul Kurdyak
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Centre for Addiction and Mental Health, Campbell Family Mental Health Research Institute, Toronto, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, Canada
- ICES University of Toronto, Mental Health and Addictions Research Program, Toronto, Canada
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26
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Matheson AI, Colombara DV, Pennucci A, Chan A, Shannon T, Suter M, Laurent AA. A Good Farewell? Positive Exits from Federal Housing Assistance and Lower Acute Healthcare Utilization. J Urban Health 2023; 100:1202-1211. [PMID: 38012503 PMCID: PMC10728032 DOI: 10.1007/s11524-023-00789-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2023] [Indexed: 11/29/2023]
Abstract
Little is known regarding the health outcomes of people who exit from housing assistance and if that experience varies by the circumstances under which a person exits. We asked two questions: (1) does the type of exit from housing assistance matter for healthcare utilization? And (2) how does each exit type compare to remaining in housing assistance in terms of healthcare utilization? This retrospective cohort study of 5550 exits between 2012 and 2018 used data from two large, urban public housing authorities in King County, Washington. Exposures were exiting from housing assistance and type of exit (positive, neutral, negative). Outcomes were emergency department visits, hospitalizations, and well-child checks (among those aged < 6) in the year following exit from housing assistance. After adjustment for demographics and baseline healthcare utilization, people with positive exits had 26% (95% confident interval: 6-39%) lower odds of having 1 + ED visits in the year following exit than people with negative exits and 20% (95% CI: 6-31%) lower odds than those who continued receiving housing assistance. Neutral and negative exits did not differ substantially from each other, and both exit types appear to be detrimental to health, with higher levels of ED visits and hospitalizations and lower levels of well-child checks. Why people exit from housing assistance matters. Those with negative exits experience poorer outcomes and efforts should be made to both prevent this kind of exit and mitigate its impact.
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Affiliation(s)
- Alastair I Matheson
- Public Health - Seattle & King County, Seattle, WA, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Danny V Colombara
- Public Health - Seattle & King County, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | | | - Andy Chan
- Seattle Housing Authority, Seattle, WA, USA
| | | | - Megan Suter
- Public Health - Seattle & King County, Seattle, WA, USA
| | - Amy A Laurent
- Public Health - Seattle & King County, Seattle, WA, USA
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27
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Nabaweesi R, Hanna M, Muthuka JK, Samuels AD, Brown V, Schwartz D, Ekadi G. The Built Environment as a Social Determinant of Health. Prim Care 2023; 50:591-599. [PMID: 37866833 DOI: 10.1016/j.pop.2023.04.012] [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: 10/24/2023]
Abstract
The built environment encompasses buildings we live in; the distribution systems that provide us with water and electricity; and the roads, bridges, and transportation systems we use to get from place to place. It provides safety, health, and well-being and meaning to its dwellers, as a place to work, live, learn, play, and thrive. Poor-quality housing affects dwellers' health through toxins such as radon and lead, mold, cold indoor temperatures, and overcrowding. Physicians' practices should investigate their patients' diagnoses such as stress, depression, asthma, adverse childhood experiences, and anxiety, as potentially housing-related and make ameliorating recommendations or referrals.
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Affiliation(s)
- Rosemary Nabaweesi
- Center for Health Policy, School of Graduate Studies, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN 37208, USA.
| | - Marie Hanna
- Family Medicine, PGY-3, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN 37208, USA
| | - John K Muthuka
- Kenya Medical Training College, PO Box 30195-00100, Nairobi, Kenya. https://twitter.com/johnmuthuka1
| | - Adrian D Samuels
- Center for Health Policy, School of Graduate Studies, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN 37208, USA
| | - Vanisha Brown
- School of Graduate Studies, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN 37208, USA
| | - Dawn Schwartz
- Department of Health Policy, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 1201, Nashville, TN 37203, USA
| | - Green Ekadi
- School of Graduate Studies, Meharry Medical College, 1005 Dr. D. B. Todd Jr. Boulevard, Nashville, TN 37208, USA
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Harp R, Byrne M, Monroe A, Castel AD. Housing, HIV outcomes, and related comorbidities in persons living with HIV in Washington, DC. AIDS Care 2023; 35:1874-1884. [PMID: 36449782 PMCID: PMC10227182 DOI: 10.1080/09540121.2022.2151557] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 11/21/2022] [Indexed: 12/02/2022]
Abstract
Housing instability can hinder the ability of people with HIV (PWH) to maintain engagement in care, adhere to antiretroviral (ART) regimens, and achieve viral suppression. This analysis examined the association between housing instability and HIV outcomes, as well as the association between housing status and substance use disorders, mental health disorders, and sexually transmitted infections. Multivariable logistic regressions were performed using data from the DC Cohort, a longitudinal cohort of PWH. Among 8622 PWH, unstably housed PWH were significantly more likely to be prescribed ART (aOR: 1.4; 95%CI: 1.1, 1.8) yet were significantly less likely to be virally suppressed (aOR: 0.6; 95%CI: 0.5, 0.8). Unstably housed PWH were also significantly more likely to have a substance use or mental health disorder, which may inhibit PWH's ability to achieve viral suppression. Efforts to end the HIV epidemic should address housing to ensure treatment is optimized for key populations.
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Affiliation(s)
- Rachel Harp
- Department of Epidemiology, Milken Institute School of Public Health of the George Washington University, Washington, DC, USA
| | - Morgan Byrne
- Department of Epidemiology, Milken Institute School of Public Health of the George Washington University, Washington, DC, USA
| | - Anne Monroe
- Department of Epidemiology, Milken Institute School of Public Health of the George Washington University, Washington, DC, USA
| | - Amanda D Castel
- Department of Epidemiology, Milken Institute School of Public Health of the George Washington University, Washington, DC, USA
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29
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Mosen DM, Banegas MP, Keast EM, Dickerson JF. Examining the Association of Social Needs with Future Health Care Utilization in an Older Adult Population: Which Needs Are Most Important? Popul Health Manag 2023; 26:413-419. [PMID: 37943589 PMCID: PMC10698796 DOI: 10.1089/pop.2023.0171] [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] [Indexed: 11/10/2023] Open
Abstract
Abstract Social needs, such as social isolation and food insecurity, are important individual-level social determinants of health, especially for adults ages 65 years and older. These needs may be associated with future health care utilization, but this research area has not been studied extensively. The objective of this study was to examine the independent association of 5 individual social needs with future (1) emergency department (ED) visits and (2) hospital admissions. This observational study included 9649 Kaiser Permanente Northwest (KPNW) Medicare members who completed the Medicare Total Health Assessment (MTHA) quality improvement survey between August 17, 2020 and January 31, 2022. The 5 social needs assessed by the MTHA, defined as binary measures (yes/no), included (1) financial strain, (2) food insecurity, (3) housing instability, (4) social isolation, and (5) transportation needs. ED utilization (yes/no) and hospitalization (yes/no), the current study outcome measures, were measured in the 12 months after MTHA assessment. In multivariable analyses, 3 of the 5 social needs were significantly associated with higher ED utilization: financial strain (odds ratio [OR] = 1.40, 95% confidence interval [CI] = 1.11-1.76, P < 0.05), housing instability (OR = 1.43, 95% CI = 1.02-1.99, P < 0.05), and social isolation (OR = 1.19, 95% CI = 1.05-1.34, P < 0.05), and 1, financial strain, was significantly associated with hospital admissions (OR = 1.66, 95% CI = 1.23-2.23, P < 0.05). The study results identified which social needs are most strongly associated with future ED utilization and hospital admissions. Further research is needed to better understand whether addressing social needs is associated with improved patient-level health outcomes over time.
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Affiliation(s)
- David M. Mosen
- Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - Matthew P. Banegas
- Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
- Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California, USA
| | - Erin M. Keast
- Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
| | - John F. Dickerson
- Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, Oregon, USA
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30
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Kim C, Rossen LM, Stierman B, Garrison V, Hales CM, Ogden CL. Federal Housing Assistance and Chronic Disease Among US Adults, 2005-2018. Prev Chronic Dis 2023; 20:E111. [PMID: 38033271 PMCID: PMC10723081 DOI: 10.5888/pcd20.230144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023] Open
Abstract
Introduction Housing insecurity is associated with poor health outcomes. Characterization of chronic disease outcomes among adults with and without housing assistance would enable housing programs to better understand their population's health care needs. Methods We used National Health and Nutrition Examination Survey (NHANES) data from 2005 through 2018 linked to US Department of Housing and Urban Development (HUD) administrative records to estimate the prevalence of obesity, diabetes, and hypertension and to assess the independent associations between housing assistance and chronic conditions among adults receiving HUD assistance and HUD-assistance-eligible adults not receiving HUD assistance at the time of their NHANES examination. We estimated propensity scores to adjust for potential confounders among linkage-eligible adults who had an income-to-poverty ratio less than 2 and were not receiving HUD assistance. Sensitivity analysis used 2013-2018 NHANES cycles to account for disability status. Results Adults not receiving HUD assistance had a significantly lower adjusted prevalence of obesity (42.1%; 95% CI, 40.4%-43.8%) compared with adults receiving HUD assistance (47.5%; 95% CI, 44.8%-50.3%), but we found no differences for diabetes and hypertension. We found significant associations between housing assistance and obesity (adjusted odds ratio = 1.29; 95% CI, 1.12-1.47), but these were not significant in the sensitivity analysis with and without controlling for disability status. We found no significant associations between housing assistance and diabetes or hypertension. Conclusion Based on data from a cross-sectional survey, we observed a higher prevalence of obesity among adults with HUD assistance compared with HUD-assistance-eligible adults without HUD assistance. Results from this study can help inform research on understanding the prevalence of chronic disease among adults with HUD assistance.
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Affiliation(s)
- Christine Kim
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
- Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta GA 30329-4027
| | - Lauren M Rossen
- Division of Research and Methodology, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Bryan Stierman
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Veronica Garrison
- Office of Research, Evaluation, and Monitoring, Office of Policy Development and Research, US Department of Housing and Urban Development, Washington, DC
| | - Craig M Hales
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
| | - Cynthia L Ogden
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Maryland
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Jia F, Liu X, Wang Y, Ma M. The effect of housing tenure on health status of migrant populations in China: are health service utilization and social integration mediating factors? Arch Public Health 2023; 81:200. [PMID: 37981711 PMCID: PMC10659080 DOI: 10.1186/s13690-023-01218-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/11/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Current research suggests that there is an association between housing tenure and the health status of migrant populations, but the potential mediators of this association remain to be explored. We aimed to examine the effect of housing tenure on migrant populations' health in China and how this effect is mediated by health service utilization and social integration. METHODS Data from the 2017 China Migrants Dynamic Survey of 47,459 participants was used. Logistic regression models were used to explore the effects of housing tenure, health service utilization, and social integration on the health status of migrant populations. Mediated effects models were used to explore the association among them. This study used the bootstrap method and KHB method to test the mediating effect of health service utilization and social integration. RESULTS Compared to private renters, owners with mortgages (OR: 0.828, 95% CI: 0.765-0.896) were significantly associated with a higher risk of poor health. Compared with private renters, outright owners were associated with a lower risk of poor health (OR: 1.016, 95% CI: 0.935, 1.104), but the association was not statistically significant (p > 0.05). Moreover, health service utilization (OR: 1.422, 95% CI: 1.268, 1.594) and social integration (OR: 4.357, 95% CI: 3.555, 5.341) were both significantly associated with a higher probability of good health (p < 0.001). CONCLUSION Among migrant populations, homeowners with mortgages had a lower likelihood of good health than private renters, while there was no significant difference in the health status between outright owners and private renters. Moreover, health service utilization and social integration mediate the effect of housing tenure on the health status of migrant populations. Policies and interventions can be designed to improve the health service utilization and social inclusion of migrant populations to reduce health disparities across housing tenure types.
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Affiliation(s)
- Fulin Jia
- Business School of Zhengzhou University, No.100, Science Avenue, Gaoxin District, Zhengzhou, 450001, Henan, China
| | - Xiaonan Liu
- Business School of Zhengzhou University, No.100, Science Avenue, Gaoxin District, Zhengzhou, 450001, Henan, China
| | - Yuxiang Wang
- School of Management, Zhengzhou University, No.100, Science Avenue, Gaoxin District, Zhengzhou, 450001, Henan, China
| | - Mingze Ma
- Department of Health Management, College of Public Health, Zhengzhou University, No.100, Science Avenue, Gaoxin District, Zhengzhou, 450001, Henan, China.
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McElroy B, Walsh E. A happy home? Socio-economic inequalities in depressive symptoms and the role of housing quality in nine European countries. BMC Public Health 2023; 23:2203. [PMID: 37940939 PMCID: PMC10634013 DOI: 10.1186/s12889-023-17070-z] [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: 01/28/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND This study examines the prevalence of and socio-economic inequalities in depressive symptoms in nine high-income European countries, focusing in particular on the role of housing quality. METHODS Using the European Social Survey, a concentration index of depressive symptoms in each country is estimated. The role of housing quality is assessed by examining the risk factors associated with the concentration index, using the Recentred Influence Function method. To contextualise the housing quality results, other predictors of inequalities in depressive symptoms inequalities are also quantified and discussed. RESULTS Our results indicate that inequalities in depressive symptoms are concentrated among poorer respondents both in each country and in total. Austria and Belgium have the lowest inequalities and France has the highest. No geographic pattern is evident. Housing problems are associated with higher inequalities in six of the nine countries in the sample. While no association is evident for indicators of socio-economic status such as years of education and income, financial strain is significant. CONCLUSIONS This study is the first to estimate the degree of socio-economic inequality in depressive symptoms across European countries. The association between poor housing and poorer inequalities suggests that housing has a role to play lowering depressive symptoms inequalities.
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Affiliation(s)
- Brendan McElroy
- Dept of Economics, Cork University Business School, University College Cork, Cork, Ireland.
| | - Edel Walsh
- Dept of Economics, Cork University Business School, University College Cork, Cork, Ireland
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Mishra SR, Wilson T, Andrabi H, Ouakrim DA, Li A, Akpan E, Bentley R, Blakely T. The total health gains and cost savings of eradicating cold housing in Australia. Soc Sci Med 2023; 334:115954. [PMID: 37672848 DOI: 10.1016/j.socscimed.2023.115954] [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: 12/07/2022] [Revised: 05/02/2023] [Accepted: 05/04/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Cold indoor temperature (<18 °C) is associated with hypertension-related and respiratory disease, depression, and anxiety. We estimate total health, health expenditure and income impacts of permanently lifting the temperature in living areas of the home to 18 °C in cold homes in South-eastern Australia (N = 17 million). METHODS A proportional multistate lifetable model was used to estimate health adjusted life years (HALYs), health expenditure and income earnings, over the remainder of the lifespan of the population alive in 2021 (3% discount rate). Multiple data were integrated including the prevalence of cold housing (5.87%; mean temperature 15 °C), the effect of temperature to hypertension-related, respiratory disease, depression and anxiety. FINDINGS Eradicating cold housing was predicted to lead to 89,600 (95% UI 47,700 to 177,000) lifetime HALYs gained over the population's remaining lifespan, nearly half of which occurred from 2021 to 2040. Respiratory disease (32.4%) and mental illness (60.6%) made large contributions to HALYs gained, but also had large uncertainty (95% UI 30.0%-42.9% and 45.1%-64.6%, respectively) due to uncertain estimates of their magnitude of causal association with cold housing. Health gains per capita were 6.1 times greater (95% UI 4.7 to 8.1) among the most compared to least deprived quintile. From 2021 to 2040, health expenditure decreased by AUD$0.87 billion (0.35-1.98) and income earnings increased by AUD$4.35 billion (1.89-9.81). INTERPRETATION Eliminating cold housing would lead to substantial health gains, reductions in health inequalities, savings in health expenditure, and productivity gains. Next steps require research to reduce uncertainty about the magnitude of causal associations of cold with mental and respiratory health.
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Affiliation(s)
- Shiva Raj Mishra
- Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
| | - Tim Wilson
- Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Hassan Andrabi
- Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia; Centre for Brain, Mind, and Markets, Department of Finance, University of Melbourne, Melbourne, Australia
| | - Driss Ait Ouakrim
- Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Ang Li
- Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Edifofon Akpan
- Centre for Health Economics and Development, Abuja, Nigeria
| | - Rebecca Bentley
- Healthy Housing, Centre for Health Policy, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Tony Blakely
- Scalable Health Intervention Evaluation (SHINE), Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
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Shalaby WS, Shukla AG, Shiuey EJ, Rapuano CJ, Nagra PK, Syed ZA. Demographic and Socioeconomic Determinants of Penetrating Keratoplasty Outcomes. Cornea 2023; 42:1274-1279. [PMID: 36729026 DOI: 10.1097/ico.0000000000003217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 11/10/2022] [Indexed: 02/03/2023]
Abstract
PURPOSE The aim of this study was to determine possible associations between demographic and socioeconomic factors and graft survival after penetrating keratoplasty (PK). METHODS This study was a retrospective chart review of patients undergoing PK at a tertiary-care corneal practice at Wills Eye Hospital between May 1, 2007, and September 1, 2018. The first PK of the first eye was included. The primary outcome measure was graft failure, defined as irreversible and visually significant graft edema, haze, or scarring. Demographic and socioeconomic factors included yearly average adjusted gross income (AGI) based on residential zip code, age, sex, and race. Two income groups were created: 1) individuals from neighborhoods with the lowest 10% of AGI (N = 82, AGI=$32,100 ± 4000) and 2) the remaining 90% of individuals (N = 740, AGI=$86,900 ± 52,200). Logistic regression analysis was performed to identify factors predictive of graft prognosis. RESULTS The 822 patients (822 eyes) included had a mean age of 57.1 ± 22.1 years at the time of PK. Over an average of 4.2 ± 3.1 years of follow-up, graft failure occurred in 35.3%. Age, sex, and follow-up duration were comparable between income groups (all P > 0.05). Black race was disproportionately represented in the lower-income group (50.0% vs. 11.5%, P < 0.001). Multivariable analysis identified predictors of graft failure including residing in a lower-income neighborhood [hazard ratio (HR) = 2.27, 95% confidence interval (CI) = 1.24-4.19, P = 0.008], younger age (HR = 0.99, 95% CI = 0.98-1.00, P = 0.046), and Black race (HR = 1.63, 95% CI = 1.03-2.56, P = 0.035). CONCLUSIONS Individuals with a lower income, younger age, and Black race may be more vulnerable to graft failure after PK. Further studies are warranted to identify reasons for these associations.
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Affiliation(s)
- Wesam Shamseldin Shalaby
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Tanta Medical School, Tanta University, Tanta, Gharbia, Egypt; and
| | - Aakriti Garg Shukla
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Eric J Shiuey
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Christopher J Rapuano
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Parveen K Nagra
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Zeba A Syed
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
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Brown EM, Moineddin R, Hapsari A, Gozdyra P, Durant S, Pinto AD. Eviction filings during bans on enforcement throughout the COVID-19 pandemic: an interrupted time series analysis. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:745-754. [PMID: 37581748 PMCID: PMC10485221 DOI: 10.17269/s41997-023-00813-1] [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: 01/13/2023] [Accepted: 07/12/2023] [Indexed: 08/16/2023]
Abstract
OBJECTIVE Bans on evictions were implemented to reduce the spread of COVID-19 and to protect vulnerable populations during a public health crisis. Our objective was to examine how three bans on eviction enforcement impacted eviction filings from March 2020 through January 2022 in Ontario, Canada. METHODS Data were derived from eviction application records kept by the Ontario Landlord and Tenant Board. We used segmented regression analysis to model changes in the average weekly filing rates for evictions due to non-payment of rent (L1 filings) and reasons other than non-payment of rent (L2 filings). RESULTS The average number of weekly L1 and L2 applications dropped by 67.5 (95% CI: 55.2, 79.9) and 31.7 (95% CI: 26.7, 36.6) filings per 100,000 rental dwellings, respectively, following the first ban on eviction enforcement (p < 0.0001). Notably, they did not fall to zero. Level changes during the second and third bans were insubstantial and slope changes for L2 applications varied throughout the study period. The L1 filing rate appeared to increase towards the end of the study period (slope change: 1.3; 95% CI: 0.1, 2.6; p = 0.0387). CONCLUSION Our findings suggest that while the first ban on eviction enforcement appeared to substantially reduce filing rates, subsequent bans were less effective and none of them eliminated eviction filings altogether. Enacting upstream policies that tackle the root causes of displacement would better equip jurisdictions during future public health emergencies.
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Affiliation(s)
- Erika M Brown
- California Policy Lab, Institute for Research on Labor & Employment, University of California, Berkeley, Berkeley, CA, USA
- Social Interventions Research & Evaluation Network, University of California, San Francisco, San Francisco, CA, USA
| | - Rahim Moineddin
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Ayu Hapsari
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Peter Gozdyra
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Steve Durant
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada
| | - Andrew D Pinto
- Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Upstream Lab, MAP/Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, ON, Canada.
- Department of Family and Community Medicine, St. Michael's Hospital, Toronto, ON, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Sarmadi M, Bagherian Z, Ahmadi-Soleimani SM, Rezaiemanesh MR, Khodamoradi F, Rahimi S, Azizi H. Environmental health risk factors and cutaneous leishmaniasis (CL): A case-control study in northeastern Iran. J Vector Borne Dis 2023; 60:372-381. [PMID: 38174514 DOI: 10.4103/0972-9062.374236] [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: 01/05/2024] Open
Abstract
Background & objectives Cutaneous leishmaniasis (CL) is one of the main causes of vector-born diseases in younger population. To evaluate the association of environmental health factors on the odds of CL incidence, a case-control study was conducted in northeastern Iran. Methods This study was conducted within 2020-2021 based on individual and household data from a tertiary referral center. Cases were patients diagnosed with CL by PCR method; controls were selected among the patients' relatives, and information was obtained from a health registry system. Demographic and socioeconomic data of 1871 subjects, included age, sex, household information and environmental health factors. Multivariable models with environmental factors in various conditions and CL were separately fit by univariate and mixed multiple unconditional logistic regression. Results Participants included 617 cases (mean [SD] age, 13.62[13.72] years; 58.20% male) and 1264 controls (mean [SD] age, 16.45[15.44] years; 50.40% male). Results revealed that the use of well-water sources compared to surface water is significantly associated with CL (odds ratio [OR]=0.204; 95%CI, 0.13-0.33;P<0.001). Muddy houses, ruined buildings or wastelands and stagnant water, canals and rivers near the houses were also associated with CL (OR=3.85; 95%CI, 1.66-8.89; P=.002; OR=2.47; 95%CI, 1.76-3.47; P<.001). Besides, existence of pine tree was found to be a risk factor (OR=3.25; 95%CI, 2.12-4.99; P<.001) and similarly for the use of waste collection system (OR=4.43; 95%CI, 3.32-7.51; P<.001). Interpretation & conclusion Environmental factors related to houses were significantly associated with CL and may represent the modifiable risk factors of CL disease.
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Affiliation(s)
- Mohammad Sarmadi
- Department of Environmental Health Engineering, School of Health; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Zahra Bagherian
- Student Research Committee, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - S Mohammad Ahmadi-Soleimani
- Health Sciences Research Center; Department of Physiology, School of Medicine, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Mohammad Reza Rezaiemanesh
- Health Sciences Research Center; Department of Laboratory Sciences, School of Paramedical Sciences, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Farzad Khodamoradi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sajjad Rahimi
- Department of Environmental Health Engineering, School of Health; Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Hakim Azizi
- Department of Medical Parasitology, School of Medicine, Zabol University of Medical Sciences, Zabol, Iran
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Lorentzen JC, Georgellis A, Albin M, Jonsson M. Residential overcrowding in relation to children's health, environment and schooling - a qualitative study. Scand J Public Health 2023:14034948231198285. [PMID: 37723969 DOI: 10.1177/14034948231198285] [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: 09/20/2023]
Abstract
AIM To explore how overcrowding affects children's health, environment and schooling. METHODS A qualitative study was conducted with individual interviews among 20 participants with occupational experience from overcrowded Stockholm areas but diverse in professions, locations and employers. The interviews were recorded, transcribed and analysed with Systematic Text Condensation. RESULTS Almost all participants expressed that overcrowding has a negative impact on children's health, environment and schooling - based on perceptions of precarious and different living conditions for children in overcrowded areas, for example, substandard homes, vulnerability, stress, exclusion, limited resources, lack of learning opportunities, gender differences, confinement, shame, insecurity, conflicts, risk of criminality, and bodily impact, both physical and psychological. CONCLUSIONS Our qualitative evidence suggest that overcrowding has a negative impact on children's health, environment and schooling.
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Affiliation(s)
- Johnny C Lorentzen
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
- Institute of Environmental Medicine, Integrative Toxicology, Karolinska Institutet, Stockholm, Sweden
| | - Antonios Georgellis
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
- Institute of Environmental Medicine, Environmental Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Maria Albin
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
- Institute of Environmental Medicine, Occupational Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marina Jonsson
- Centre for Occupational and Environmental Medicine, Region Stockholm, Sweden
- Institute of Environmental Medicine, Environmental Epidemiology, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
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Gao C, Sanchez KM, Lovinsky-Desir S. Structural and Social Determinants of Inequitable Environmental Exposures in the United States. Clin Chest Med 2023; 44:451-467. [PMID: 37517826 DOI: 10.1016/j.ccm.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
American Indian (AI)/Alaskan Natives, African Americans, and Latino Americans have disproportionally high exposure to harmful environmental conditions as a consequence of unjust laws and policies, systemic racism, residential segregation, and discrimination. In this review, we draw connections between historical policies and social movements in the United States' history that have been rooted in racism and classism, leading to social isolation and marginalization of AIs, African Americans, and Latino Americans. We then discuss the structural factors that stem from the aforementioned inequities and that contribute to the inequitable distribution of environmental hazards.
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Affiliation(s)
- Courtney Gao
- Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHC 7-701, New York, NY, USA
| | - Kimberly M Sanchez
- Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHC 7-701, New York, NY, USA
| | - Stephanie Lovinsky-Desir
- Pulmonary Division, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, 3959 Broadway, CHC 7-701, New York, NY 10032, USA.
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Rauf T. Differential sensitivity to adversity by income: Evidence from a study of Bereavement. SOCIAL SCIENCE RESEARCH 2023; 115:102920. [PMID: 37858363 DOI: 10.1016/j.ssresearch.2023.102920] [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: 04/19/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 10/21/2023]
Abstract
Adverse life events are often understood as having negative consequences for mental health via objective hardships, which are worse for persons with less income. But adversity can also affect mental health via more subjective mechanisms, and here, it is possible that persons with higher income will exhibit greater psychological sensitivity to negative events, for various reasons. Drawing on multiple sociological literatures, this article theorizes potential mechanisms of increasing sensitivity with income. The proposition of differential sensitivity is tested using the strategic case of spousal and parental bereavement among older US adults. The analyses find consistent evidence of increasing sensitivity of depressive symptoms with income. A series of robustness checks indicate that findings are not due to endogenous or antecedent selection. Further, exploratory analyses of mechanisms suggest that higher sensitivity among the affluent was driven by greater expectations and better relationship quality with the deceased. These findings problematize the conceptualization and assessment of human suffering in economically stratified societies.
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Affiliation(s)
- Tamkinat Rauf
- Department of Sociology, University of Wisconsin-Madison, 1180 Observatory Drive, Madison, WI, 53706, USA.
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Bjorklund E. The needle and the damage done: Deaths of despair, economic precarity, and the white working-class. Soc Sci Med 2023; 333:116153. [PMID: 37572630 DOI: 10.1016/j.socscimed.2023.116153] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 07/25/2023] [Accepted: 08/05/2023] [Indexed: 08/14/2023]
Abstract
Economic insecurity has grown in the United States since the 1970s impacting all segments of the working-class, including previously insulated sub-groups such as non-Hispanic whites. Moreover, the white working-class has experienced a surge in socio-cultural isolation, and disengagement with societal institutions. This analysis focuses on the health consequences of these developments, with a particular emphasis on the rising "deaths of despair" (suicide, drug poisoning, alcohol related). These deaths have been increasing since the mid-1990s and, at least until recently, tended to be clustered amongst whites without a four-year college degree. Various competing explanations have been put forth, emphasizing distinct factors such as material conditions, socio-cultural dynamics, and accessibility to opioids. Using a series of linear models this analysis examines the county-level association between economic precarity, white working-class population size, opioid accessibility, and deaths of despair. Results affirm the net effect of each predictor and illuminate an interactive relationship between opioid accessibility and precarity, as well as an interactive relationship between all three predictors. By undertaking an interdisciplinary synthesis of existing research, this study contributes to the understanding of the social determinants of mortality while providing crucial insights into an ongoing crisis in contemporary America.
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Affiliation(s)
- Eric Bjorklund
- School of Social & Family Dynamics, Arizona State University, 951 Cady Hall, Tempe, AZ 85287, USA.
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Jafree SR, Shah G, Zakar R, Muzamill A, Ahsan H, Burhan SK, Javed A, Durrani RR. Characterizing Social Determinants of Maternal and Child Health: A Qualitative Community Health Needs Assessment in Underserved Areas. Healthcare (Basel) 2023; 11:2224. [PMID: 37570465 PMCID: PMC10418942 DOI: 10.3390/healthcare11152224] [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: 05/13/2023] [Revised: 07/26/2023] [Accepted: 08/05/2023] [Indexed: 08/13/2023] Open
Abstract
This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants included basic health unit healthcare staff, women of reproductive ages, male family members, mothers-in-law, and religious leaders. We found that maternal and child health is adversely affected by the following socioeconomic and environmental barriers: (i) poor housing quality and sanitation; (ii) inadequate food supply and safety; (iii) unsatisfactory public sector school services; (iv) a lack of safety and security; (v) scarce poverty alleviation efforts and loan schemes; (vi) unsatisfactory transport and internet services; and (vii) inadequate health services. The targets for maternal and child health in Pakistan cannot be met without close coordination between the primary health sector, local governance, and macro state structures, which collectively must monitor and improve housing adequacy, food security, public sector services (primary healthcare services, public schooling, public transport, and public internet access), overall safety, and poverty emergence.
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Affiliation(s)
- Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University, Zahoor Elahi Road, Lahore 54600, Pakistan;
| | - Gulzar Shah
- Department of Health Policy and Community Health Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30460, USA
| | - Rubeena Zakar
- Institute of Social and Cultural Studies, University of the Punjab, Lahore 54590, Pakistan;
| | - Anam Muzamill
- Department of Mass Communications, Forman Christian College University, Lahore 54600, Pakistan;
| | - Humna Ahsan
- Department of Economics, Forman Christian College University, Lahore 54600, Pakistan;
| | - Syeda Khadija Burhan
- Department of Education, Forman Christian College University, Lahore 54600, Pakistan;
| | - Ambreen Javed
- Department of English, Forman Christian College University, Lahore 54600, Pakistan;
| | - Rana Rubab Durrani
- Center for Language Development, Forman Christian College University, Lahore 54600, Pakistan;
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Moghadam TT, Ochoa Morales CE, Lopez Zambrano MJ, Bruton K, O'Sullivan DTJ. Energy efficient ventilation and indoor air quality in the context of COVID-19 - A systematic review. RENEWABLE & SUSTAINABLE ENERGY REVIEWS 2023; 182:113356. [PMID: 37220488 PMCID: PMC10186986 DOI: 10.1016/j.rser.2023.113356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/02/2023] [Accepted: 05/08/2023] [Indexed: 05/25/2023]
Abstract
New COVID-19 ventilation guidelines have resulted in higher energy consumption to maintain indoor air quality (IAQ), and energy efficiency has become a secondary concern. Despite the significance of the studies conducted on COVID-19 ventilation requirements, a comprehensive investigation of the associated energy challenges has not been discussed. This study aims to present a critical systematic review of the Coronavirus viral spreading risk mitigation through ventilation systems (VS) and its relation to energy use. COVID-19 heating, ventilation and air conditioning (HVAC)-related countermeasures proposed by industry professionals have been reviewed and their influence on operating VS and energy consumption have also been discussed. A critical review analysis was then conducted on publications from 2020 to 2022. Four research questions (RQs) have been selected for this review concerning i) maturity of the existing literature, ii) building types and occupancy profile, iii) ventilation types and effective control strategies and iv) challenges and related causes. The results reveal that employing HVAC auxiliary equipment is mostly effective and increased fresh air supply is the most significant challenge associated with increased energy consumption due to maintaining IAQ. Future studies should focus on novel approaches toward solving the apparently conflicting objectives of minimizing energy consumption and maximizing IAQ. Also, effective ventilation control strategies should be assessed in various buildings with different occupancy densities. The implications of this study can be useful for future development of this topic not only to enhance the energy efficiency of the VS but also to enable more resiliency and health in buildings.
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Affiliation(s)
- Talie T Moghadam
- Intelligent Efficiency Research Group (IERG), University College Cork, Cork, Ireland
| | | | | | - Ken Bruton
- Intelligent Efficiency Research Group (IERG), University College Cork, Cork, Ireland
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Roberts JA, Mohan A. Housing in Delaware for the Intellectual and Developmental Disabilities Population. Dela J Public Health 2023; 9:30-33. [PMID: 37622146 PMCID: PMC10445611 DOI: 10.32481/djph.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
Individuals with intellectual and developmental disabilities (IDD) encounter numerous barriers in attempting to access housing. Those barriers - financial, physical, and cultural in nature - have been exacerbated by the COVID-19 public health emergency and the related, or co-occurring, shifts that have characterized the housing market in the United States, and Delaware specifically, over these last three years. In this brief introductory research report, we examine the system of housing supports and their availability to individuals with IDD through a subset of those served by the state's Division of Developmental Disabilities Services through interviews with representatives across the housing support system. Our findings fall into four areas of work: scale and scope; housing availability; housing assistance; and housing supports. We find that: the estimated scale of the housing crisis (in terms of homelessness and insecurity) affecting this population is much greater than the general population, but in line with other national estimates for individuals with IDD; there is limited available housing that is accessible to individuals with IDD available in the state; there is limited assistance available for navigating the housing that might be available; and that there are too few options for providing more supports for individuals living, or trying to live, independently. We conclude with a few suggested recommendations that could provide more reliable data and tracking of need and a call for research that connects housing for individuals with IDD into the growing body of research looking at the relationship between access to housing and health.
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Millard K, Metraux S. Gauging and Responding to the Need for Home Repair Assistance in Delaware. Dela J Public Health 2023; 9:54-58. [PMID: 37622148 PMCID: PMC10445617 DOI: 10.32481/djph.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023] Open
Abstract
We review the extent of the need for home repair assistance for low-income homeowners in Delaware, and steps being taken to address this need. Delaware contains an estimated 25,000 homes owned by low-income households that need repair, of which an estimated 5,000 are in substandard condition. There is an estimated $96 million total cost associated with this home repair need, with eighty percent of this cost ($76 million) coming from the twenty percent (5,000) of these homes that are in substandard condition. In order to address this need for repair assistance, Delaware's three Habitat for Humanity organizations have designed the Statewide Healthy Homes Program, which centers on the intersection of health and housing. The vision of the Habitat for Humanity Statewide Healthy Homes Program is to increase capacity for home repair assistance across Delaware. Additionally, the program seeks to include partnerships with healthcare providers to ensure a holistic approach to home repairs, improving each resident's quality of life.
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Affiliation(s)
- Katharine Millard
- Sussex County Habitat for Humanity
- Joseph R. Biden, Jr. School of Public Policy & Administration, University of Delaware
| | - Stephen Metraux
- Joseph R. Biden, Jr. School of Public Policy & Administration, University of Delaware
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Francová O, Korhonen K, Kovačević D. Quality of life: A way to buttress crisis program evaluations? EVALUATION AND PROGRAM PLANNING 2023; 99:102316. [PMID: 37244098 DOI: 10.1016/j.evalprogplan.2023.102316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/04/2023] [Accepted: 05/18/2023] [Indexed: 05/29/2023]
Abstract
To test the applicability of the quality of life concept (QoL) in evaluations of financial assistance programs to sovereigns, we apply the OECD well-being framework to the programs in a euro area country, and find that the multidimensional framework promises policy-relevant findings, capable of informing other approaches for evaluating program relevance and effectiveness. The framework's headline indicators nevertheless, needed to be complemented with additional indicators owing to data challenges. The well-being dimensions demonstrate that our primary country case and other assisted euro area countries struggled to protect some vulnerable groups before and during the crisis years, although many QoL indicators depict improvement once program completion approached. In many cases, gender, age and education level related differences were apparent, and should be better considered in future crisis programs. The framework also facilitates considering governance elements with our enhancements. It offers good grounds for deepening the understanding of stakeholders' perception of reform benefits or shortcomings, thus of program ownership. By using the OECD framework we explore some interpretative limits of QoL in evaluation, and underscore that a full program evaluation would require careful integration in primary case data. Further research and data set improvements would enhance this approach's utility.
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Affiliation(s)
- Olga Francová
- European Stability Mechanism, 6a, Circuit de la foire internationale, L-1347, Luxembourg
| | - Kari Korhonen
- European Stability Mechanism, 6a, Circuit de la foire internationale, L-1347, Luxembourg.
| | - Dušan Kovačević
- European Stability Mechanism, 6a, Circuit de la foire internationale, L-1347, Luxembourg
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Fortunato F, Lillini R, Martinelli D, Iannelli G, Ascatigno L, Casanova G, Lopalco PL, Prato R. Association of socio-economic deprivation with COVID-19 incidence and fatality during the first wave of the pandemic in Italy: lessons learned from a local register-based study. Int J Health Geogr 2023; 22:10. [PMID: 37143110 PMCID: PMC10157567 DOI: 10.1186/s12942-023-00332-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 04/26/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND COVID-19 has been characterised by its global and rapid spread, with high infection, hospitalisation, and mortality rates worldwide. However, the course of the pandemic showed differences in chronology and intensity in different geographical areas and countries, probably due to a multitude of factors. Among these, socio-economic deprivation has been supposed to play a substantial role, although available evidence is not fully in agreement. Our study aimed to assess incidence and fatality rates of COVID-19 across the levels of socio-economic deprivation during the first epidemic wave (March-May 2020) in the Italian Province of Foggia, Apulia Region. METHODS Based on the data of the regional active surveillance platform, we performed a retrospective epidemiological study among all COVID-19 confirmed cases that occurred in the Apulian District of Foggia, Italy, from March 1st to May 5th, 2020. Geocoded addresses were linked to the individual Census Tract (CT) of residence. Effects of socio-economic condition were calculated by means of the Socio-Economic and Health-related Deprivation Index (SEHDI) on COVID-19 incidence and fatality. RESULTS Of the 1054 confirmed COVID-19 cases, 537 (50.9%) were men, 682 (64.7%) were 0-64 years old, and 338 (32.1%) had pre-existing comorbidities. COVID-19 incidence was higher in the less deprived areas (p < 0.05), independently on age. The level of socio-economic deprivation did not show a significant impact on the vital status, while a higher fatality was observed in male cases (p < 0.001), cases > 65 years (p < 0.001), cases having a connection with a nursing home (p < 0.05) or having at least 1 comorbidity (p < 0.001). On the other hand, a significant protection for healthcare workers was apparent (p < 0.001). CONCLUSIONS Our findings show that deprivation alone does not affect COVID-19 incidence and fatality burden, suggesting that the burden of disease is driven by a complexity of factors not yet fully understood. Better knowledge is needed to identify subgroups at higher risk and implement effective preventive strategies.
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Affiliation(s)
- Francesca Fortunato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
| | - Roberto Lillini
- Analytical Epidemiology & Health Impact Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Domenico Martinelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Giuseppina Iannelli
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Leonardo Ascatigno
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Georgia Casanova
- IRCCS-INRCA National Institute of Health & Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy
| | - Pier Luigi Lopalco
- Department of Biological and Environmental Sciences and Technology, University of Salento, Lecce, Italy
| | - Rosa Prato
- Hygiene Unit, Policlinico Foggia Hospital, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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Richard A, Bruat C, Febvrel D, Squinazi F, Simos J, Zmirou-Navier D. Creation and testing of the Domiscore-a tool to characterize the impact of housing on health and well-being. BMC Public Health 2023; 23:815. [PMID: 37143018 PMCID: PMC10157125 DOI: 10.1186/s12889-023-15451-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 03/15/2023] [Indexed: 05/06/2023] Open
Abstract
BACKGROUND Despite evidence of the major impact housing carries on health, many individuals still live in unhealthy dwellings. In France, the Domiscore has been proposed as a tool to assess the quality of dwellings with regard to their health impact, to allow for a better detection of unsafe housing and to improve dwellings. The aim of this paper is to present the method used to construct the Domiscore and test its relevance and usability. METHODS The Domiscore grid, inspired by the Nutriscore, consists of 46 variables-such as air quality, light or outdoor view. Each variable is scored on a four-point scale using in situ observation, mandatory diagnostics and open access data. The sum of each variable's score results in an overall risk score for the dwelling. The Domiscore was tested in two phases. During the first testing phase, 11 real estate professionals, health professionals and social workers used the Domiscore for on-site visits in different geographic areas of France. They then participated in a semi-structured qualitative interview. The second phase consisted in a public consultation with diverse stakeholders such as public authorities, housing activists and social workers, using an online survey to collect their opinions on the Domiscore's relevance, understandability and usability. RESULTS The Domiscore was tested on 28 homes. Variables completion rates were high irrespective of tester profile for all home visits (91%, SD = 4.7%). The mean time needed to fill in the grid was 1.5 h. The public consultation returned 151 responses. The Domiscore was deemed easy to understand, relevant, and rather easy to fill out. Most participants found the Domiscore useful for information gathering, awareness raising, detecting at-risk situations and agreed that it could contribute to enhance housing conditions. Its length was noted, although the inclusion of additional variables was also suggested. CONCLUSIONS The results of this study suggest that the Domiscore is accessible to housing specialists and other professionals for the evaluation of a dwelling's health impacts and the standardized detection of dangerous situations. The testing process allowed for improvements in the grid and training materials for future users.
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Affiliation(s)
- Aude Richard
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Camille Bruat
- HCSP (High Council of Public Health), Paris, France.
| | | | | | - Jean Simos
- Institute of Global Health, University of Geneva, Geneva, Switzerland
- HCSP (High Council of Public Health), Paris, France
| | - Denis Zmirou-Navier
- HCSP (High Council of Public Health), Paris, France
- Université de Lorraine, Nancy, France
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Oh J. Prevalence and factors associated with multidimensional child deprivation: Findings from the Future of Families and Child Well-Being Study. CHILDREN AND YOUTH SERVICES REVIEW 2023; 148:106890. [PMID: 37736253 PMCID: PMC10512438 DOI: 10.1016/j.childyouth.2023.106890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Despite the growing importance of the multidimensional methods of assessing child poverty, few studies in the U.S. have applied a rights-based approach to examining child deprivation. This study examines multidimensional child deprivation using eight dimensions and twelve indicators based on the Convention on the Rights of the Child (CRC). Using a sample of children at age nine from the fifth wave of the Future of Families and Child Well-being Study, this study applied the multiple overlapping deprivation analysis (MODA), a comprehensive analytic method to assess the multidimensionality of child deprivation and to provide a detailed picture of material and social forms of deprivation among the U.S. children. This study found that the overall child deprivation rate was 8.89%; environmental safety (20.36%), information (15.94%), and housing security (14.23%) dimensions contributed the highest to the overall child deprivation; the overlap between deprivation and income poverty was 12.83%. Results suggest that understanding multifaceted and interrelated contexts of child deprivation is crucial to promote child rights.
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Affiliation(s)
- Jihyun Oh
- Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, United States
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Zhu Y, Holden M. Housing and psychosocial well-being during the COVID-19 pandemic. HABITAT INTERNATIONAL 2023; 135:102812. [PMID: 36992843 PMCID: PMC10033258 DOI: 10.1016/j.habitatint.2023.102812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 03/18/2023] [Accepted: 03/22/2023] [Indexed: 06/19/2023]
Abstract
The loss of psychosocial well-being is an overlooked but monumental consequence of the COVID-19 pandemic. These effects result not only from the pandemic itself but, in a secondary way, from the Non-Pharmaceutical Interventions (NPIs) made to curb the spread of disease. The unprecedented physical distancing and stay-at-home requirements and recommendations provide a unique window for housing researchers to better understand the mechanisms by which housing affects psychosocial well-being. This study draws on a survey conducted with over 2,000 residents of the neighbouring Canadian provinces of British Columbia and Alberta in 2021. We propose a new multi-dimensional model to examine the relationships between the Material, Economic, Affordances, Neighbourhood, and Stability (MEANS) aspects of housing and psychosocial well-being. Our analysis reveals the direct and indirect pathways by which deficiencies in each of these areas had negative effects on psychosocial well-being. Residential stability, housing affordances, and neighbourhood accessibility exert stronger direct impacts on psychosocial well-being than material and economic housing indicators (e.g. size of living space and tenure). Notably, we find no significant well-being differences between different homeowners and renters when we account for other housing MEANS. These findings have important implications for housing policy across pandemic and post-pandemic contexts, suggesting a need for research and policy focus on understanding housing and well-being in terms of non-material aspects, such as residential stability and affordances that housing provides.
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Affiliation(s)
- Yushu Zhu
- Simon Fraser University, 515 W Hastings St, Vancouver, BC, V6B 5K3, Canada
| | - Meg Holden
- Simon Fraser University, 515 W Hastings St, Vancouver, BC, V6B 5K3, Canada
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Zhang X, Lai Y, Bai X, Wu B, Xiang W, Zhang C, Geng G, Miao W, Xia Q, Wu Q, Yang H, Wang Y, Tian W, Cao Y, Liu X, Li H, Tian Y, Song Z, Zhao Z, Huang Z, Cheng X, Han X, Li Y, Shi B. Determining the spatial non-stationarity underlying social and natural environment in thyroid cancer in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 870:162009. [PMID: 36737014 DOI: 10.1016/j.scitotenv.2023.162009] [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: 10/28/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Light at night (LAN) is a physiological environmental factor related to thyroid cancer (TC). The spatial relationship between the number of TC incident cases, LAN, air pollution and other macro social factors and stationarity needs to be further examined to provide evidence for regional control of TC. METHODS Spatial econometrics methods for spatial nonstationarity were used to explore the impacts of LAN, air pollutants, economic factors, and population size on the number of TC incident cases in 182 Chinese prefecture-level cities and the local coefficients were further tested for nonstationarity. Temporally weighted regression (TWR), geographically weighted regression (GWR), and geographically and temporally weighted regression (GTWR) were compared in this study for model selection. RESULTS Based on the ordinary least squares (OLS), LAN, air pollutants, and urbanization all significantly affected the number of TC incident cases. GWR had the best goodness of fit, and the coefficients of all the variables passed the nonstationarity test. The strong positive impact of LAN was mainly concentrated in North China, air pollutants in Central China and neighboring regions, and urbanization in the eastern coast of China. CONCLUSIONS The locational factors of the prefecture-level city influence the spatial pattern of the number of TC incident cases. Governments should pay attention to this influence, adhere to the Health in All Policies principle, and formulate region-specific policies based on regional characteristics, which this study provides updated evidence for.
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Affiliation(s)
- Xiyu Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yongqiang Lai
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaodan Bai
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Bing Wu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Wenjing Xiang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Chenxi Zhang
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Guihong Geng
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wenqing Miao
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qi Xia
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Qunhong Wu
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Huiying Yang
- The second affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Yanjie Wang
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Wanxin Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yu Cao
- Department of Economics, School of Economics, Minzu University of China, Beijing, China
| | - Xinwei Liu
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Hongyu Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Yulu Tian
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhe Song
- The second affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Ziwen Zhao
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Zhipeng Huang
- Department of Social Medicine, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China
| | - Xiaonan Cheng
- The second affiliated hospital of Harbin Medical University, Harbin, Heilongjiang, China
| | - Xinhao Han
- Department of Biostatistics, School of Public Health, Harbin Medical University, Harbin, Heilongjiang, China
| | - Ye Li
- Research Center of Health Policy and Management, School of Health Management, Harbin Medical University, Harbin, Heilongjiang, China.
| | - Baoguo Shi
- Department of Economics, School of Economics, Minzu University of China, Beijing, China.
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