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Porter KP, Forrest K, Hearne S. Tools for Approaching Policy With Equity in Mind. J Public Health Manag Pract 2023; 29:939-940. [PMID: 37738599 DOI: 10.1097/phh.0000000000001831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/24/2023]
Affiliation(s)
- Keshia Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Drs Pollack Porter and Hearne); and CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente (Ms Forrest)
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Duren M, Corrigan B, Ehsani J, Kennedy RD, Pollack Porter K. Individual and environmental bicycling determinants during a pandemic. J Transp Health 2023; 31:101632. [PMID: 37304835 PMCID: PMC10247188 DOI: 10.1016/j.jth.2023.101632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 05/13/2023] [Accepted: 05/24/2023] [Indexed: 06/13/2023]
Abstract
Introduction Research has identified many factors associated with bicycling, but little is known on their relative influence for an individual's decision to bicycle or what led to the surge in bicycling during the COVID-19 pandemic in the U.S. Methods Our research leverages a sample of 6735 U.S. adults to identify key predictors and their relative influence on both increased bicycling during the pandemic and on whether an individual commutes by bicycle. LASSO regression models identified a reduced set of predictors for the outcomes of interest from 55 determinants included in the modeling. Results We find individual and environmental factors have a role in explaining the shift towards bicycling-with key differences in predictors for increased overall cycling during the pandemic compared to bicycle commuting. Conclusions Our findings add to the evidence base that policies can impact bicycling behavior. Specifically, increasing e-bike accessibility and limiting residential streets to local traffic are two policies that show promise for encouraging bicycling.
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Affiliation(s)
- Michelle Duren
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States
| | - Bryce Corrigan
- Johns Hopkins Krieger School of Arts and Sciences, 3400 N Charles St, Baltimore, MD, 21218, United States
| | - Johnathon Ehsani
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States
| | - Ryan David Kennedy
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States
| | - Keshia Pollack Porter
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD, 21205, United States
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Hickson A, Purbey R, Dean L, Gallo JJ, Thorpe RJ, Pollack Porter K, Chandran A. A consequence of mass incarceration: county-level association between jail incarceration rates and poor mental health days. Health Justice 2022; 10:31. [PMID: 36269431 PMCID: PMC9587611 DOI: 10.1186/s40352-022-00194-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Mass incarceration has mental health consequences on those directly affected; some studies have also shown spillover effects on the physical health of the surrounding population. There is a dearth of research on the spillover mental health consequences of mass incarceration. This study aimed to quantify a consequence of mass incarceration which may adversely affect the population's health and widen health disparities. METHODS Using data from the Vera Institute's Incarceration Trends 2.2 and the Robert Wood Johnson County Health Rankings, the association between county-level (n = 2823) counts of jail incarceration and reported number of poor mental health days within the past 30 days in the United States in 2018 was examined. To conduct the analysis, a negative binomial regression model was fit, adjusting for State and key demographic covariates. RESULTS A change in jail incarceration rate from the first to the second and third tertiles was associated with 10.14% and 14.52% increases, respectively. For every 1% increase in the rate of mass incarceration, there was a statistically significant 15% increase in the average number of reported poor mental health days over the past 30 days. DISCUSSION Mass incarceration is a threat to mental health as well as the well-being of the surrounding population. This can be attributed to the spillover effects that extend beyond those who are directly affected by mass incarceration. Interventions to reduce jail incarceration as well as address the mental health needs of those living in high-incarceration rate areas should be prioritized in order to reduce health inequities and augment health outcomes for all residents of the United States.
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Affiliation(s)
| | - Ritika Purbey
- Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lorraine Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room E6650, Baltimore, MD, USA
| | - Joseph J Gallo
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 792, Baltimore, MD, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 708, Baltimore, MD, USA
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 380A, Baltimore, MD, USA
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Room W6501, Baltimore, MD, USA
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Duren M, Ehsani J, Michael J, Pollack Porter K. Association between perceived risk of COVID-19 and support for transportation policies. Case Stud Transp Policy 2022; 10:1898-1903. [PMID: 35971459 PMCID: PMC9365709 DOI: 10.1016/j.cstp.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 08/01/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
The association between perceived risk of COVID-19 at the individual level and support for transportation policies designed to mitigate coronavirus transmission has received little attention. We surveyed a nationally representative sample of U.S. adults (N = 2,011) in June 2020 to examine how support for public policy varied according to perceived risk. We used logistic regression models to control for demographic factors and identify the effect of perceived risk, defined as a combination of self-reported perceptions of personal risk of acquiring the disease and the severity of the illness if infected, on support for a range of policies related to transportation. We found that perceived risk did not vary significantly by sex, race, urbanicity, income, or age. Support for policies aimed at mitigating COVID-19 transmission was consistently higher among those with higher perceived risk of the disease.
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Affiliation(s)
- Michelle Duren
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
| | - Johnathon Ehsani
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
| | - Jeffrey Michael
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
| | - Keshia Pollack Porter
- Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, United States
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Jock BW, Maudrie T, Fleischhacker S, Porter KP, Gittelsohn J. Journey to Promoting Structural Change for Chronic Disease Prevention: Examining the Processes for Developing Policy, Systems, and Environmental Supports in Native American Nations. Curr Dev Nutr 2022; 6:nzab031. [PMID: 35310617 PMCID: PMC8923812 DOI: 10.1093/cdn/nzab031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/23/2020] [Accepted: 03/31/2021] [Indexed: 11/29/2022] Open
Abstract
Background Obesity and chronic disease rates continue to be disproportionally high among Native Americans (NAs) compared with the US general population. Policy, systems, and environmental (PSE) changes can address the root causes of these health inequalities by supporting access to healthy food and physical activity resources. Objective We aim to describe the actors and processes involved in developing PSE changes supporting obesity prevention in NA Nations. Methods As part of the Obesity Prevention Research and Evaluation of InterVention Effectiveness in NaTive North Americans 2 (OPREVENT2) trial (ClinicalTrials.gov registration: NCT02803853), we collected 46 in-depth interviews, 1 modified Talking Circle, 2 workshops, and 14 observations in 3 NA communities in the Midwest and Southwest regions of the United States. Participants included Tribal government representatives/staff, health staff/board members, store managers/staff, and school administrators/staff. We used a Grounded Theory analysis protocol to develop themes and conceptual framework based on our data. Results Health staff members were influential in identifying and developing PSE changes when there was a strong relationship between the Tribal Council and health department leaders. We found that Tribal Council members looked to health staff for their expertise and were involved in the approval and endorsement of PSE changes. Tribal grant writers worked across departments to leverage existing initiatives, funding, and approvals to achieve PSE changes. Participants emphasized that community engagement was a necessary input for developing PSE changes, suggesting an important role for grassroots collaboration with community members and staff. Relevant contextual factors impacting the PSE change development included historical trauma, perspectives of policy, and "tribal politics". Conclusions This article is the first to produce a conceptual framework using 3 different NA communities, which is an important gap to be addressed if structural changes are to be explored and enacted to promote NA health. The journey to change for these NA Nations provides insights for promoting future PSE change among NA Nations and communities.
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Affiliation(s)
- Brittany Wenniserí:iostha Jock
- School of Human Nutrition, Centre for Indigenous Peoples’ Nutrition and Environment (CINE), McGill University, St-Anne-de-Bellevue, Quebec, Canada
| | - Tara Maudrie
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Joel Gittelsohn
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Prochnow T, Umstattd Meyer MR, Pollack Porter K. I Play, You Play, We Play: Concurrent Activity at Play Streets. Res Q Exerc Sport 2022; 93:53-63. [PMID: 32865475 DOI: 10.1080/02701367.2020.1792399] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/27/2020] [Indexed: 06/11/2023]
Abstract
Purpose: Despite multiple health benefits, many children and teens do not achieve recommended amounts of physical activity (PA). Temporary changes to the built environment like Play Streets, temporarily closing streets to create safe places to play, are one solution to encourage PA in summer months. Play Streets can promote social cohesion by creating opportunities for concurrent activity, being active in the same area simultaneously. This study assesses concurrent activity at Chicago PlayStreets. Methods: During summer 2018, the System for Observing Play and Recreation in Communities (SOPARC) and iSOPARC mobile application were used to measure PA at PlayStreets (n = 11) organized by eight community partners. Odds ratios were used to determine odds of observing an individual as active when in the same target area as another individual, and when in the same target area as an active individual, separated by sex and age categories. Results: Presence of an active individual significantly increased odds of observing an individual as active for several sex and age stratifications. Specifically, presence of active children or an active male adult significantly increased odds of observing children and teens as active. In contrast, presence of another person alone was not shown to significantly increase odds of observing an individual as active, except in two instances when stratified by sex and age. Conclusions: Active male adults have a significant positive impact on activity levels at PlayStreets underlining the importance of engaged male figures. Additionally, findings suggest that active children can promote PA among other children at PlayStreets.
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Steeves EA, Trude ACB, Ruggiero CF, Ruiz MJM, Jones-Smith JC, Porter KP, Cheskin L, Hurley K, Hopkins L, Gittelsohn J. Perceptions and Impact of a Youth-led Childhood Obesity Prevention Intervention among Youth-leaders. J Hunger Environ Nutr 2021; 16:213-234. [PMID: 34539947 DOI: 10.1080/19320248.2019.1649777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective To evaluate the impact of a youth-led nutrition intervention on youth-leaders themselves. Design Mixed methods, including: in-depth interviews and a quasi-experimental quantitative study comparing youth-leaders and nonparticipant comparison youth. Analysis Qualitative analysis using direct content analysis. Difference-in-differences analyses assessing quantitative program impact. Results Youth-leaders perceived that the intervention impacted themselves, the youth-participants, and their respective social networks. Youth-leaders experienced greater increases in intentions to eat healthfully (p=0.04), and greater decreases in support for healthy eating from their friends (p=0.01), than the comparison group. Conclusions/Implications Youth-leaders reported multiple levels of intervention impact, and increased intentions for healthy eating; however, additional research is needed to enhance impact on behavioral outcomes.
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Affiliation(s)
| | - Angela Cristina Bizzotto Trude
- Center for Human Nutrition and the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health
| | | | | | | | - Keshia Pollack Porter
- Department of Health Policy and Management and the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health
| | - Lawrence Cheskin
- Department of Health Behavior and Society and the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health
| | - Kristen Hurley
- Center for Human Nutrition and the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health
| | | | - Joel Gittelsohn
- Center for Human Nutrition and the Global Obesity Prevention Center at the Johns Hopkins Bloomberg School of Public Health
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Green GA, Porter KP, Conte S, Valadka AB, Soloff L, Curriero FC. Preventing Concussions From Foul Tips and Backswings in Professional Baseball: Catchers' Perceptions of and Experiences With Conventional and Hockey-Style Masks. Clin J Sport Med 2021; 31:e1-e7. [PMID: 30358617 DOI: 10.1097/jsm.0000000000000679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To understand catchers' preferences for mask type and perceptions regarding safety, comfort, and fit, and determine whether mask type is correlated with self-reported concussion and related symptoms after impacts from foul tips or backswings. DESIGN Cross-sectional study. SETTING Survey of active baseball catchers. PARTICIPANTS Professional baseball catchers. INTERVENTION From May 1, 2015, to June 30, 2015, an online survey was administered in English and Spanish to all Major and Minor League catchers (n = 836). MAIN OUTCOME MEASURES Survey items addressed the type of mask routinely and previously used (conventional or hockey style); brand and material (steel or titanium); perceptions regarding safety, comfort, and fit; and experiences with concussions. RESULTS The sample consisted of 596 catchers of which 26% reported being diagnosed with a concussion. Some concussions occurred from non-baseball activities, such as car accidents or off the field incidents. For those that occurred playing baseball, 35% resulted from a foul tip. Once catchers entered professional baseball, the use of a conventional mask rose significantly: 71% of catchers reported wearing conventional-style masks, and 30% hockey-style masks at the time the survey was conducted (P < 0.05). Both conventional and hockey-style mask wearers significantly selected hockey-style masks as providing better overall safety and protection than conventional masks (P < 0.05). CONCLUSIONS This research supports foul tips as an important cause of concussion in catchers and provides important information about preferences among catchers for masks that are not perceived as the safest and strongest. Future research should supplement these data by conducting laboratory testing to determine which masks are stronger and by collecting qualitative data to explore why some players are more likely to wear a mask type that they perceive as offering less safety or protection.
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Affiliation(s)
- Gary Alan Green
- UCLA Division of Sports Medicine, Pacific Palisades Medical Group, Pacific Palisades, California
| | - Keshia Pollack Porter
- Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Stan Conte
- Baseball Medicine, Conte Injury Analytics, Santa Clara University
| | - Alex B Valadka
- Department of Neurosurgery, Virginia Commonwealth University, Richmond, Virginia
| | - Lonnie Soloff
- Medical Services, Cleveland Indians Baseball, Cleveland, Ohio; and
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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Bui DP, Griffin SC, French DD, Hu C, Pollack Porter K, Jung AM, Crothers S, Burgess JL. The use of proactive risk management to reduce emergency service vehicle crashes among firefighters. J Safety Res 2019; 71:103-109. [PMID: 31862021 DOI: 10.1016/j.jsr.2019.09.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/12/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Emergency service vehicle crashes (ESVCs), including rollovers and collisions with other vehicles and fixed objects, are a leading cause of death among U.S. firefighters. Risk management (RM) is a proactive intervention to identifying and mitigating occupational risks and hazards. The goal of this study was to assess the effect of RM in reducing ESVCs. METHODS Three fire departments (A, B and C), representing urban and suburban geographies, and serving medium to large populations, participated in facilitated RM programs to reduce their ESVCs. Interventions were chosen by each department to address their department-specific circumstances and highest risks. Monthly crash rates per 10,000 calls were calculated for each department an average of 28 months before and 23 months after the start of the RM programs. Interrupted time series analysis was used to assess the effect of the RM programs on monthly crash rates. Poisson regression was used to estimate the number of crashes avoided. Economic data from Department A were analyzed to estimate cost savings. RESULTS Department A had a 15.4% (P = 0.30) reduction in the overall monthly crash rate immediately post-RM and a 1% (P = 0.18) decline per month thereafter. The estimated two-year average cost savings due to 167 crashes avoided was $253,100 (95%CI= $192,355 - $313,885). Department B had a 9.7% (P = 0.70) increase in the overall monthly crash rate immediately post-RM and showed no significant changes in their monthly crash rate. Department C had a 28.4% (P = 0.001) reduction in overall monthly crash rate immediately post-RM and a 1.2% (P = 0.09) increase per month thereafter, with an estimated 122 crashes avoided. CONCLUSIONS RM programs have the potential to reduce ESVCs in the fire service and their associated costs; results may vary based on the interventions chosen and how they are implemented. Practical applications: Risk management may be an effective and broadly implemented intervention to reduce ESVCs in the US fire service.
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Affiliation(s)
- David P Bui
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
| | - Stephanie C Griffin
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
| | - Dustin D French
- Center for Healthcare Studies, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA.
| | - Chengcheng Hu
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
| | - Keshia Pollack Porter
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Injury Research and Policy, Baltimore, MD, USA.
| | - Alesia M Jung
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
| | | | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Tucson, AZ, USA.
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Jarman MP, Curriero FC, Haut ER, Pollack Porter K, Castillo RC. Associations of Distance to Trauma Care, Community Income, and Neighborhood Median Age With Rates of Injury Mortality. JAMA Surg 2019; 153:535-543. [PMID: 29417146 DOI: 10.1001/jamasurg.2017.6133] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Importance Rural, low-income, and historically underrepresented minority communities face substantial barriers to trauma care and experience high injury incidence and mortality rates. Characteristics of injury incident locations may contribute to poor injury outcomes. Objective To examine the association of injury scene characteristics with injury mortality. Design, Setting, and Participants In this cross-sectional study, data from trauma center and emergency medical services provided by emergency medical services companies and designated trauma centers in the state of Maryland from January 1, 2015, to December 31, 2015, were geocoded by injury incident locations and linked with injury scene characteristics. Participants included adults who experienced traumatic injury in Maryland and were transported to a designated trauma center or died while in emergency medical services care at the incident scene or in transit. Exposures The primary exposures of interest were geographic characteristics of injury incident locations, including distance to the nearest trauma center, designation level and ownership status of the nearest trauma center, and land use, as well as community-level characteristics such as median age and per capita income. Main Outcomes and Measures Odds of death were estimated with multilevel logistic regression, controlling for individual demographic measures and measures of injury and health. Results Of the 16 082 patients included in this study, 8716 (52.4%) were white, and 5838 (36.3%) were African American. Most patients were male (10 582; 65.8%) and younger than 65 years (12 383; 77.0%). Odds of death increased by 8.0% for every 5-mile increase in distance to the nearest trauma center (OR, 1.08; 95% CI, 1.01-1.15; P = .03). Compared with privately owned level 1 or 2 centers, odds of death increased by 49.9% when the nearest trauma center was level 3 (OR, 1.50; 95% CI, 1.06-2.11; P = .02), and by 80.7% when the nearest trauma center was publicly owned (OR, 1.81; 95% CI, 1.39-2.34; P < .001). At the zip code tabulation area level, odds of death increased by 16.0% for every 5-year increase in median age (OR, 1.16; 95% CI, 1.03-1.30; P = .02), and decreased by 26.6% when the per capita income was greater than $25 000 (OR, 0.73; 95% CI, 0.54-0.99; P = .05). Conclusions and Relevance Injury scene characteristics are associated with injury mortality. Odds of death are highest for patients injured in communities with higher median age or lower per capita income and at locations farthest from level 1 or 2 trauma centers.
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Affiliation(s)
- Molly P Jarman
- Center for Surgery and Public Health Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts.,Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Elliott R Haut
- Department of Surgery, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Renan C Castillo
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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Jarman MP, Pollack Porter K, Curriero FC, Castillo RC. Factors mediating demographic determinants of injury mortality. Ann Epidemiol 2019; 34:58-64.e2. [PMID: 31053454 DOI: 10.1016/j.annepidem.2019.03.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 02/20/2019] [Accepted: 03/24/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Elevated injury mortality rates persist for men and people of color despite attempts to standardize trauma care in the United States. This study investigates the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. METHODS Data on prehospital and trauma center care were examined for adult injured patients in Maryland who were transported by emergency medical services to designated trauma centers (n = 15,355) or who died while under emergency medical services care (n = 727). Potential mediators of the relationship between demographic characteristics and injury mortality were identified through exploratory analyses. Total, direct, and indirect effects of race, ethnicity, and sex were estimated using multivariable mediation models. RESULTS Prehospital time, hospital distance, injury mechanism, and insurance status mediated the effect of African American race, resulting in a 5.7% total increase (95% CI: 1.6%, 9.9%) and 5.6% direct decrease (95% CI: 1.1%, 9.9%) in odds of death. Mechanism, insurance, and distance mediated the effect of Hispanic ethnicity, resulting in an 11.4% total decrease (95% CI: 6.4%, 16.2%) and 13.4% direct decrease (95% CI: 8.1%, 18.3%) in odds of death. Injury severity, mechanism, insurance, and time mediated the effect of male sex, resulting in a 27.3% total increase (95% CI: 21.6%, 10.9%) and a 6.2% direct increase (95% CI: 1.8%, 10.9%) in odds of death. CONCLUSIONS Distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
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Affiliation(s)
- Molly P Jarman
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA.
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD
| | - Renan C Castillo
- Department of Health Policy and Management, Johns Hopkins School of Public Health, Baltimore, MD
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Cowling K, Stuart EA, Neff RA, Magraw D, Vernick J, Porter KP. World Trade Organization membership and changes in noncommunicable disease risk factors: a comparative interrupted time-series analysis, 1980-2013. Bull World Health Organ 2019; 97:83-96A. [PMID: 30728615 PMCID: PMC6357569 DOI: 10.2471/blt.18.218057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 10/06/2018] [Accepted: 10/08/2018] [Indexed: 11/27/2022] Open
Abstract
Objective To investigate the relationship between joining the World Trade Organization (WTO) and the availability of several commodities with both harmful and protective effects for the development of noncommunicable diseases. Methods We used a natural experiment design to compare trends in the domestic supply of tobacco, alcohol and seven food groups, between 1980 and 2013, in 21 countries or territories joining WTO after 1995 and 26 non-member countries, using propensity score weights. We applied a comparative interrupted time-series framework, by using multivariate random-effects linear models, adjusted for gross domestic product per capita, the percentages of urban population and female labour force participation. In the tobacco model, we controlled for Member States that had ratified the Framework Convention on Tobacco Control and in the alcohol model, the percentage of the population identifying themselves as Muslim. Findings Following accession to WTO, member states experienced immediate increases in the domestic supply of fruits and vegetables of 55 g per person per day on average, compared to non-member countries. The analysis showed gradual increases in the geometric mean of the supply of tobacco and alcohol of 6.2% and 3.6% per year, respectively. We did not detect any significant changes in the availability of red meats and animal fats; seafood; nuts, seeds and legumes; starches; or edible oils; and results for sugars were inconsistent across model variations. Conclusion The results suggest that WTO membership may lead to increases in both harmful and protective factors for noncommunicable disease, but further exploration of country-specific variation is warranted.
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Affiliation(s)
- Krycia Cowling
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 380A, Baltimore, MD 21205, United States of America (USA)
| | - Elizabeth A Stuart
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Roni A Neff
- Center for a Livable Future, Department of Environmental Health & Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Daniel Magraw
- Paul H. Nitze School of Advanced International Studies, Johns Hopkins University, Baltimore, USA
| | - Jon Vernick
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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Gutermuth LK, Hager ER, Pollack Porter K. Using the CDC's Worksite Health ScoreCard as a Framework to Examine Worksite Health Promotion and Physical Activity. Prev Chronic Dis 2018; 15:E84. [PMID: 29935077 PMCID: PMC6016402 DOI: 10.5888/pcd15.170463] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Introduction Worksite health promotion programs are emerging as an effective approach for addressing the adult obesity epidemic and improving the overall health of employees. Methods We conducted a scoping review to identify articles that described a physical activity component (eg, promoted increased physical or reduced sitting time) of a worksite health promotion intervention. Our search specified full-length articles published in English from January 2000 through July 2015. We used the Centers for Disease Control and Prevention’s Worksite Health ScoreCard, a validated tool, as a framework to summarize information on organizational supports strategies (18 questions) and physical activity strategies (9 questions) implemented by worksite health promotion programs. We also determined whether or not the included studies reported significant (P < .05) improvements in physical activity. Results We identified 18 worksite health promotion programs; 11 produced significant improvements in physical activity. Incentives, health risk assessments, health promotion committees, leadership support, marketing, and subsidies or discounts for use of exercise facilities were the most effective organizational supports strategies cited, and physical activity seminars, classes, and workshops were the most effective physical activity strategies cited. Conclusion The use of the Health ScoreCard allowed for a practical interpretation of our findings, which can inform next steps for the field. Future research should explore the relationships between components of worksite health promotion programs and their outcomes to further develop best practices that can improve worker health and promote physical activity.
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Affiliation(s)
- Leah K Gutermuth
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, 737 W. Lombard St, 163, Baltimore, MD 21201.
| | - Erin R Hager
- Department of Pediatrics, Growth and Nutrition Division, University of Maryland School of Medicine, Baltimore, Maryland
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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14
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Bui DP, Balland S, Giblin C, Jung AM, Kramer S, Peng A, Aquino MCP, Griffin S, French DD, Pollack Porter K, Crothers S, Burgess JL. Interventions and controls to prevent emergency service vehicle incidents: A mixed methods review. Accid Anal Prev 2018; 115:189-201. [PMID: 29621721 DOI: 10.1016/j.aap.2018.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/14/2017] [Accepted: 01/06/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Emergency service vehicle incidents (ESVI), including crashes, rollovers, and roadside struck-by-incidents, are a leading cause of occupational fatality and injury among firefighters and other emergency responders. Though there are numerous strategies and interventions to prevent ESVIs, the evidence base for these strategies is limited and dispersed. The goal of this study was to gather and present a review of evidence-based ESVI interventions. METHODS We searched five academic databases for articles published within the last decade featuring interventions to reduce or prevent ESVIs. We interviewed key informants from fire departments serving major metropolitan areas for additional interventions. Interventions from both sources were summarized and data on intervention effectiveness were reported when available. RESULTS Sixty-five articles were included in the final review and 17 key informant interviews were completed. Most articles focused on vehicle engineering interventions (38%), followed by policy and administration interventions (26%), environmental engineering interventions (19%) and education or training (17%). Most key informants reported policy (49%) and training interventions (29%). Enhanced drivers' training and risk management programs were associated with 19-50% and 19-58% reductions in ESVIs, respectively. CONCLUSIONS Only a limited number of interventions to address ESVIs had adequate outcome data. Based on the available data, training and risk management approaches may be particularly effective approaches to reducing ESVIs.
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Affiliation(s)
- David P Bui
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA.
| | - Samantha Balland
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Casey Giblin
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Alesia M Jung
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Sandy Kramer
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Abigail Peng
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Marie Corazon Ponce Aquino
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Stephanie Griffin
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
| | - Dustin D French
- Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, 645 North Michigan Avenue, Suite 440, Chicago, IL 60611, USA; Center for Healthcare Studies, Feinberg School of Medicine, Northwestern University, 633 N. Saint Clair, 20th Floor, Chicago, IL 60611, USA; Veterans Affairs Health Services Research and Development Service, Chicago, 5000 5th Ave, Hines, IL 60141, USA
| | - Keshia Pollack Porter
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Injury Research and Policy, 615 N Wolfe St, Baltimore, MS 21205, USA
| | - Steve Crothers
- Seattle Fire Department, 301 2nd Ave S, Seattle, WA 98104, USA
| | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, 1295 N Martin Ave, Tucson, AZ 85724, USA
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15
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Cowling K, Thow AM, Pollack Porter K. Analyzing the impacts of global trade and investment on non-communicable diseases and risk factors: a critical review of methodological approaches used in quantitative analyses. Global Health 2018; 14:53. [PMID: 29793510 PMCID: PMC5968469 DOI: 10.1186/s12992-018-0371-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 05/10/2018] [Indexed: 11/14/2022] Open
Abstract
Background A key mechanism through which globalization has impacted health is the liberalization of trade and investment, yet relatively few studies to date have used quantitative methods to investigate the impacts of global trade and investment policies on non-communicable diseases and risk factors. Recent reviews of this literature have found heterogeneity in results and a range of quality across studies, which may be in part attributable to a lack of conceptual clarity and methodological inconsistencies. Methods This study is a critical review of methodological approaches used in the quantitative literature on global trade and investment and diet, tobacco, alcohol, and related health outcomes, with the objective of developing recommendations and providing resources to guide future robust, policy relevant research. A review of reviews, expert review, and reference tracing were employed to identify relevant studies, which were evaluated using a novel quality assessment tool designed for this research. Results Eight review articles and 34 quantitative studies were identified for inclusion. Important ways to improve this literature were identified and discussed: clearly defining exposures of interest and not conflating trade and investment; exploring mechanisms of broader relationships; increasing the use of individual-level data; ensuring consensus and consistency in key confounding variables; utilizing more sector-specific versus economy-wide trade and investment indicators; testing and adequately adjusting for autocorrelation and endogeneity when using longitudinal data; and presenting results from alternative statistical models and sensitivity analyses. To guide the development of future analyses, recommendations for international data sources for selected trade and investment indicators, as well as key gaps in the literature, are presented. Conclusion More methodologically rigorous and consistent approaches in future quantitative studies on the impacts of global trade and investment policies on non-communicable diseases and risk factors can help to resolve inconsistencies of existing research and generate useful information to guide policy decisions. Electronic supplementary material The online version of this article (10.1186/s12992-018-0371-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Krycia Cowling
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 380A, Baltimore, MD, 21205, USA.
| | - Anne Marie Thow
- Menzies Centre for Health Policy, School of Public Health, The University of Sydney, D17 Charles Perkins Centre, Sydney, NSW, 2006, Australia
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 380A, Baltimore, MD, 21205, USA
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16
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Poplin GS, Griffin S, Pollack Porter K, Mallett J, Hu C, Day-Nash V, Burgess JL. Efficacy of a proactive health and safety risk management system in the fire service. Inj Epidemiol 2018; 5:18. [PMID: 29658098 PMCID: PMC5899967 DOI: 10.1186/s40621-018-0148-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/06/2018] [Indexed: 11/10/2022] Open
Abstract
Background This study evaluated the efficacy of a fire department proactive risk management program aimed at reducing firefighter injuries and their associated costs. Methods Injury data were collected for the intervention fire department and a contemporary control department. Workers’ compensation claim frequency and costs were analyzed for the intervention fire department only. Total, exercise, patient transport, and fireground operations injury rates were calculated for both fire departments. Results There was a post-intervention average annual reduction in injuries (13%), workers’ compensation injury claims (30%) and claims costs (21%). Median monthly injury rates comparing the post-intervention to the pre-intervention period did not show statistically significant changes in either the intervention or control fire department. Conclusions Reduced workers’ compensation claims and costs were observed following the risk management intervention, but changes in injury rates were not statistically significant.
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Affiliation(s)
- Gerald S Poplin
- Center for Applied Biomechanics, School of Engineering and Applied Sciences, University of Virginia, Charlottesville, USA
| | - Stephanie Griffin
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | | | - Joshua Mallett
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Chengcheng Hu
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Virginia Day-Nash
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA.
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17
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Bui DP, Pollack Porter K, Griffin S, French DD, Jung AM, Crothers S, Burgess JL. Correction to: Risk management of emergency service vehicle crashes in the United States fire service: process, outputs, and recommendations. BMC Public Health 2017; 17:923. [PMID: 29195498 PMCID: PMC5712151 DOI: 10.1186/s12889-017-4946-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/27/2017] [Indexed: 11/10/2022] Open
Affiliation(s)
- David P Bui
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Drachman Hall, 1295 N Martin Ave, Campus PO Box: 245210, Tucson, AZ, 85724, USA.
| | - Keshia Pollack Porter
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Injury Research and Policy, Baltimore, MD, USA
| | - Stephanie Griffin
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Drachman Hall, 1295 N Martin Ave, Campus PO Box: 245210, Tucson, AZ, 85724, USA
| | - Dustin D French
- Center for Healthcare Studies, Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.,Department of Veterans Affairs, Center of Innovation for Complex Chronic Healthcare, Edward Hines, Jr. VA Hospital, Hines, IL, USA
| | - Alesia M Jung
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Drachman Hall, 1295 N Martin Ave, Campus PO Box: 245210, Tucson, AZ, 85724, USA
| | | | - Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, The University of Arizona, Drachman Hall, 1295 N Martin Ave, Campus PO Box: 245210, Tucson, AZ, 85724, USA
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18
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Mui Y, Jones-Smith JC, Thornton RLJ, Pollack Porter K, Gittelsohn J. Relationships between Vacant Homes and Food Swamps: A Longitudinal Study of an Urban Food Environment. Int J Environ Res Public Health 2017; 14:ijerph14111426. [PMID: 29160811 PMCID: PMC5708065 DOI: 10.3390/ijerph14111426] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 11/07/2017] [Accepted: 11/07/2017] [Indexed: 12/04/2022]
Abstract
Research indicates that living in neighborhoods with high concentrations of boarded-up vacant homes is associated with premature mortality due to cancer and diabetes, but the mechanism for this relationship is unclear. Boarded-up housing may indirectly impact residents’ health by affecting their food environment. We evaluated the association between changes in vacancy rates and changes in the density of unhealthy food outlets as a proportion of all food outlets, termed the food swamp index, in Baltimore, MD (USA) from 2001 to 2012, using neighborhood fixed-effects linear regression models. Over the study period, the average food swamp index increased from 93.5 to 95.3 percentage points across all neighborhoods. Among non-African American neighborhoods, increases in the vacancy rate were associated with statistically significant decreases in the food swamp index (b = −0.38; 90% CI, −0.64 to −0.12; p-value: 0.015), after accounting for changes in neighborhood SES, racial diversity, and population size. A positive association was found among low-SES neighborhoods (b = 0.15; 90% CI, 0.037 to 0.27; p-value: 0.031). Vacant homes may influence the composition of food outlets in urban neighborhoods. Future research should further elucidate the mechanisms by which more distal, contextual factors, such as boarded-up vacant homes, may affect food choices and diet-related health outcomes.
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Affiliation(s)
- Yeeli Mui
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Jessica C Jones-Smith
- Department of Health Services & Nutritional Sciences Program, School of Public Health, University of Washington, Seattle, WA 98195, USA.
| | - Rachel L J Thornton
- Center for Child and Community Health Research, Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
| | - Keshia Pollack Porter
- Department of Health Policy and Management, Institute for Health and Social Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
| | - Joel Gittelsohn
- Center for Human Nutrition, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
- Global Obesity Prevention Center (GOPC) at Johns Hopkins University, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
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