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Puleo BK, Dillon FR, Ertl MM, Da Silva N, Cabrera Tineo YA, Verile M, De La Rosa M. Neighborhood Collective Efficacy: A Longitudinal Social Determinant of Access to Medical Care Among Recently Immigrated Latina Young Adults. Hisp Health Care Int 2024; 22:83-91. [PMID: 37455338 DOI: 10.1177/15404153231187394] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
The present longitudinal study examined changes in perceived access to health care among a recently immigrated cohort of Latina young adults who were assessed annually during their first 3 years in the United States. A parallel process growth model of perceived access to health care and neighborhood collective efficacy was examined, accounting for socioeconomic indicators and immigration status. Five hundred thirty Latina young adults (ages 18-23) participated at baseline assessment, and approximately 95% were retained over three annual assessment time points. Participants' mean level of perceived access to health care increased during their initial 3 years in the United States. Women who reported more of an increase in perceived access to health care tended to also indicate increased neighborhood collective efficacy relative to their peers during their first 3 years in the United States. Findings offer important information about the individual- and community-level factors that influence recently immigrated Latinas' health care access.
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Affiliation(s)
- Blair K Puleo
- School of Counseling and Counseling Psychology, Arizona State University, Tempe, AR, USA
| | - Frank R Dillon
- School of Counseling and Counseling Psychology, Arizona State University, Tempe, AR, USA
| | - Melissa M Ertl
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Nicole Da Silva
- Department of Educational and Counseling Psychology, University at Albany - State University of New York, Albany, NY, USA
| | - Yajaira A Cabrera Tineo
- Department of Educational and Counseling Psychology, University at Albany - State University of New York, Albany, NY, USA
| | - Michael Verile
- Department of Educational and Counseling Psychology, University at Albany - State University of New York, Albany, NY, USA
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Zhang D. Perceived Neighborhood Conditions, Psychosocial Factors, and Sleep Problems Among Urban and Rural Older Adults in China. J Aging Health 2024; 36:337-349. [PMID: 37395560 DOI: 10.1177/08982643231159709] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
OBJECTIVES To examine the associations between perceived neighborhood conditions and older Chinese adults' sleep problems, and whether these associations are mediated by psychosocial factors and moderated by urban-rural residence. METHODS Data were from the World Health Organization Study on global Ageing and Adult Health. We used OLS, binary, and multinomial logistic regression analyses. Karlson-Holm-Breen decomposition method was used to test mediation effects. RESULTS Positively perceived neighborhood social cohesion was associated with fewer insomnia symptoms and decreased odds of poor sleep quality, sleepiness, lethargy, and short sleep duration. Positively perceived neighborhood safety was related to decreased risks of poor sleep quality and sleepiness. Depression and perceived control partially mediated the effects of perceived neighborhood on sleep. Furthermore, the protective effects of neighborhood cohesion against sleep problems were more pronounced among older urban adults than their rural counterparts. DISCUSSION Interventions that make neighborhoods safer and more integrated will improve late-life sleep health.
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Affiliation(s)
- Dan Zhang
- School of Public Administration, Hohai University, Nanjing, China
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Tuomola EM, Keskinen KE, Viljanen A, Rantanen T, Portegijs E. Neighborhood Walkability, Walking Difficulties, and Participation in Leisure Activities Among Older People: A Cross-Sectional Study and 4-Year Follow-Up of a Subsample. J Aging Health 2024; 36:367-378. [PMID: 37482698 PMCID: PMC11025300 DOI: 10.1177/08982643231191444] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Objectives: To study cross-sectional and longitudinal associations between objectively assessed neighborhood walkability, walking difficulties, and participation in leisure activities among older people. Methods: Self-reported 2 km walking difficulty (intact, modifications, difficulties) at baseline and participating in organized group, outdoor recreation and cultural activities at baseline and follow-up were studied in community-dwelling persons (N = 848) aged 75-90. A walkability index, calculated using a geographic information system, was categorized into tertiles (lowest, middle, highest). Results: Residence in the highest walkability areas was associated with higher participation in cultural activities and lower participation in outdoor recreation, while the latter was most frequently reported by residents in the lowest walkability areas. Those reporting no difficulties were more likely than those reporting difficulties to participate in all studied activities. Residence in the middle or highest walkability areas predicted higher participation in cultural activities at follow-up. Discussion: Older persons activity profiles associate with neighborhood walkability and walking difficulties.
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Affiliation(s)
- Essi-Mari Tuomola
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Kirsi E. Keskinen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Anne Viljanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Taina Rantanen
- Faculty of Sport and Health Sciences and Gerontology Research Center, University of Jyvaskyla, Jyväskylä, Finland
| | - Erja Portegijs
- University Medical Center Groningen, Center for Human Movement Sciences, University of Groningen, Groningen, The Netherlands
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Zheng Y, Lin T, Hamm NAS, Liu J, Zhou T, Geng H, Zhang J, Ye H, Zhang G, Wang X, Chen T. Quantitative evaluation of urban green exposure and its impact on human health: A case study on the 3-30-300 green space rule. Sci Total Environ 2024; 924:171461. [PMID: 38461976 DOI: 10.1016/j.scitotenv.2024.171461] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/12/2023] [Accepted: 03/01/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND AND AIMS Urban green spaces offer various health benefits, yet the impact of comprehensive green exposure criteria on multidimensional health remains unclear. The 3-30-300 green space rule represents the green exposure indicators with specific thresholds. This study aims to quantitatively evaluate urban green exposure in cities and can support investigation of its relationship with human health. METHODS We conducted a cross-sectional study based on 902 investigated individuals in 261 residential locations aged 11-95 years from Xiamen City, China. 3-30-300 green exposure was calculated using field surveys, GIS, and Baidu Maps Application Programming Interface (API). Physical health data was based on Occupational Stress Indicator (OSI)-2. Mental health was from the 12-item General Health Questionnaire (GHQ-12). Social health was from a self-constructed evaluation questionnaire. Statistical analyses were conducted using Geographically Weighted Regression and Geographically Weighted Logistic Regression for global and local effects on green exposure and multidimensional health. RESULT Among the investigated individuals, only 3.55 % (32/902) fully meet the 3-30-300 rule in Xiamen. Global results show that individuals achieved at least 30 % vegetation coverage (Yes) is associated with better physical (β: 0.76, p < 0.01) and social (β: 0.5, p < 0.01) health. GWLR global results indicate that individuals can "see at least 3 trees from home" meeting one (OR = 0.46, 95%CI: 0.25-0.86, p < 0.05) or two (OR = 0.41, 95%CI: 0.22,0.78, p < 0.01; OR = 0.24, 95%CI: 0.07-0.77, p < 0.05) 3-30-300 rule components are significantly associated with reduced medical visits and hospitalizations refer to not met these criterias. In the GWR local analysis, achieved 30 % vegetation cover is significantly related to improved social health at all locations. Meeting any two indicators also contribute to improved social health (n = 511, β: 0.46-0.51, P < 0.05). CONCLUSION Green exposure indicators based on the 3-30-300 rule guiding healthy urban green space development. We observed multidimensional health benefits when 1/3 or 2/3 of the indicators were met.
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Affiliation(s)
- Yicheng Zheng
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; School of Geographical Sciences, Faculty of Science and Engineering, University of Nottingham, Ningbo 315100, China.
| | - Tao Lin
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China; CAS Haixi Industrial Technology Innovation Center in Beilun, Ningbo 315800, China.
| | - Nicholas A S Hamm
- School of Geographical Sciences, Faculty of Science and Engineering, University of Nottingham, Ningbo 315100, China.
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No. 38, Xueyuan Road, Haidian District, Beijing 100191, China; Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue Boston, Boston, MA 02115, USA.
| | - Tongyu Zhou
- Department of Architecture and Built Environment, University of Nottingham Ningbo China, Ningbo 315100, China.
| | - Hongkai Geng
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Junmao Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China.
| | - Hong Ye
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China.
| | - Guoqin Zhang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China.
| | - Xiaotong Wang
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; School of Geographical Sciences, Faculty of Science and Engineering, University of Nottingham, Ningbo 315100, China.
| | - Tianyi Chen
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen 361021, China; Fujian Key Laboratory of Digital Technology for Territorial Space Analysis and Simulation, Fuzhou 350108, China.
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Hansmann KJ, Deemer DA, Robert S. Measuring Age-Friendliness of Transportation and Mobility Characteristics in Communities: A Scoping Review. Gerontologist 2024; 64:gnad106. [PMID: 37527462 DOI: 10.1093/geront/gnad106] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Age-friendly communities are those with characteristics that can support and promote healthy aging. Among the common domains of these characteristics, transportation and neighborhood spaces are particularly relevant for older adults maintaining mobility in their communities. The objective of this scoping review is to provide a synthesis of age-friendly community indicators, developed for research and planning, that evaluate characteristics most associated with community-level mobility, specifically transportation and neighborhood spaces. RESEARCH DESIGN AND METHODS We conducted a systematic search of PubMed, Scopus, Medline, APA PsychInfo, CINAHL Plus, SocIndex, Academic Search Premier, and Web of Science. We reviewed 8 articles and reports that described the development or evaluation of a set of generalizable indicators to measure the age-friendliness of a community's transportation and neighborhood spaces resources. RESULTS Indicators of transportation and neighborhood spaces ranged from self-reported measures of accessibility and convenience to objective measures of the availability and cost of services. Explicit discussion of mobility at the community level was variable in these records, and few authors specifically discussed common life transitions impacted by these age-friendly community indicators, such as driving cessation. DISCUSSION AND IMPLICATIONS Although age-friendly communities are a well-established goal for promoting healthy aging, our review found few validated approaches for measuring age-friendliness that researchers and communities can use to investigate mobility at the community level. This is an important gap in studying life transitions such as driving cessation. Further research can provide a better understanding of which community characteristics support ongoing mobility.
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Affiliation(s)
- Kellia J Hansmann
- Geriatric Research Education and Clinical Center (GRECC), William S. Middleton Veterans Hospital, Madison, Wisconsin, USA
- Department of Family Medicine and Community Health, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - David A Deemer
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Stephanie Robert
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Goldman AW, Pinto JM. Sensory Health Among Older Adults in the United States: A Neighborhood Context Approach. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae003. [PMID: 38267366 PMCID: PMC10998359 DOI: 10.1093/geronb/gbae003] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Indexed: 01/26/2024] Open
Abstract
OBJECTIVES Sensory health declines with age but remains critical to the navigation and enjoyment of everyday life. Neighborhoods are key sites of environmental exposure, social engagement, and access to resources that can shape sensory health, yet the residential neighborhood is understudied as a determinant of sensory function. METHODS We use data from Rounds 1 and 2 of the National Social Life, Health, and Aging Project to examine how subjective and objective measures of older adults' residential areas are associated with sensory health in a series of cross-sectional and multilevel regression models. RESULTS In cross-sectional models, higher levels of perceived neighborhood social ties are associated with significantly better self-rated vision. Older adults who reside in more densely populated tracts are more likely to have significantly worse olfactory identification, whereas residing in tracts with higher levels of concentrated disadvantage is associated with significantly lower levels of self-rated vision. In multilevel models, residing in more densely populated tracts is associated with significantly worse olfactory identification, whereas tract-level concentrated disadvantage is associated with significantly worse hearing and vision. DISCUSSION We propose that neighborhood characteristics could influence certain environmental exposures, the amount of time that older adults spend out of the home, patterns of social engagement, and access to preventative care that collectively affect sensory health. Residential neighborhoods may be important sites of potential intervention to slow age-related sensory declines and other related conditions.
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Affiliation(s)
- Alyssa W Goldman
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
| | - Jayant M Pinto
- Department of Surgery, Section of Otolaryngology, University of Chicago Medicine, Chicago, Illinois, USA
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Stams GJ, van der Helm P. It takes a safe village to raise a child-a commentary on Dana McCoy et al. (2023). J Child Psychol Psychiatry 2024; 65:723-725. [PMID: 38102894 DOI: 10.1111/jcpp.13929] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Accepted: 12/04/2023] [Indexed: 12/17/2023]
Abstract
This commentary on the study by McCoy et al. (2023) examining the negative effects of neighborhood violence on the development of toddlers growing up in the city of São Paulo (Brazil) interprets these outcomes from the perspective of ecological system theory, modern brain research, and the prospect of resilience. We argue that societies should give children the opportunity to grow up in a safe and sufficiently affluent social environment in order to give them a chance to achieve their full developmental potential. Governments and the health care system should, therefore, first and foremost invest in safe and stimulating child-rearing environments, informed by scientific research.
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Jenkins Morales M, Robert SA. Does Subsidized Housing Prevent Health Decline and 2-Year Mortality Among Low-Income Older Renters? Gerontologist 2024; 64:gnad121. [PMID: 37656170 PMCID: PMC11032116 DOI: 10.1093/geront/gnad121] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND AND OBJECTIVES A growing number of older adults in the United States need subsidized housing, but only 36% of eligible households receive assistance. The purpose of this study is to examine if older renters living in subsidized housing are less likely to experience health decline and mortality over 2 years compared to low-income older renters who are likely eligible, but do not receive assistance. RESEARCH DESIGN AND METHODS Baseline data include 671 subsidized and unsubsidized low-income older renters from the 2015 National Health and Aging Trends Study. Outcomes of interest include self-rated health decline, developing a new activity limitation, or 2-year mortality between 2015 and 2017. Weighted stepwise logistic regression models test (a) if subsidized older renters were less likely to experience health decline or 2-year mortality compared to unsubsidized older renters, and (b) if housing quality and neighborhood factors mediate the association between subsidized housing and health decline/mortality. RESULTS Subsidized older renters were less likely to develop a new activity limitation compared to unsubsidized older renters, but there was not a statistically significant difference in experiencing self-rated health decline or 2-year mortality by subsidized housing status. Housing quality and neighborhood factors did not significantly mediate this association. DISCUSSION AND IMPLICATIONS The results provide some support that improving access to subsidized housing for low-income older renters may have additional health benefits, even in the short term. To inform program improvements and maximize potential health benefits, more research is needed to understand the specific health-promoting features of subsidized housing.
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Affiliation(s)
- Meghan Jenkins Morales
- BerbeeWalsh Department of Emergency Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Stephanie A Robert
- Sandra Rosenbaum School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Mitchell DN, Beams DR, Chorney SR, Kou YF, Liu P, Dabbous H, Johnson RF. Neighborhood Socioeconomic Disadvantage and Long-Term Outcomes After Pediatric Tracheostomy. Laryngoscope 2024; 134:2415-2421. [PMID: 37850858 DOI: 10.1002/lary.31117] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/15/2023] [Accepted: 10/04/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES To determine whether long-term outcomes after pediatric tracheostomy are impacted by neighborhood socioeconomic disadvantage. METHODS A prospective cohort of children with tracheostomies was followed at an academic pediatric hospital between 2015 and 2020. Patients were grouped into low or high socioeconomic disadvantage using their neighborhood area deprivation index (ADI). Survival and logistic regression analyses determined the relationship between ADI group, decannulation, and mortality. RESULTS A total of 260 children were included with a median age at tracheostomy of 6.6 months (interquartile range [IQR], 3.9-42.3). The cohort was 53% male (N = 138), 55% White race (N = 143), and 35% Black or African American (N = 90). Tracheostomy was most frequently indicated for respiratory failure (N = 189, 73%). High neighborhood socioeconomic disadvantage was noted for 66% of children (N = 172) and 61% (N = 158) had severe neurocognitive disability. ADI was not associated with time to decannulation (HR = 0.90, 95% confidence interval [95% CI]: 0.53-1.53) or time to death (HR = 0.92, 95% CI: 0.49-1.72). CONCLUSIONS Neighborhood socioeconomic disadvantage was not associated with decannulation or mortality among children with a tracheostomy. These findings suggest that long-term outcomes after pediatric tracheostomy are less dependent on socioeconomic factors in an individual community. LEVEL OF EVIDENCE 3 Laryngoscope, 134:2415-2421, 2024.
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Affiliation(s)
- Dalia N Mitchell
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
| | - Dylan R Beams
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
| | - Stephen R Chorney
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, U.S.A
| | - Yann-Fuu Kou
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, U.S.A
| | - Pamila Liu
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
| | - Helene Dabbous
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
| | - Romaine F Johnson
- Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A
- Department of Pediatric Otolaryngology, Children's Medical Center Dallas, Dallas, Texas, U.S.A
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Canham SL, Weldrick R, Mahmood A, Patille R, Erisman MC. Meanings of Aging in the Right Place for Older Clients of a Temporary Housing Program. Gerontologist 2024; 64:gnad151. [PMID: 37930091 DOI: 10.1093/geront/gnad151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The concept of aging in place is acknowledged as the preference of older adults, yet without consideration of the intersections of diversity in later life, it is critiqued as unattainable, unrealistic, or even undesirable. This gave rise to the exploration of what is needed to age in the right place (AIRP). Building on existing research, we examined the meaning of AIRP to older adults (aged 55+ years) who have experienced homelessness. RESEARCH DESIGN AND METHODS We conducted photovoice interviews with 11 residents of a temporary housing program in Metro Vancouver (Canada). RESULTS Using thematic analysis, we organized meanings of AIRP according to (1) Where one lives-the physical and social environment, (2) Where one goes and what one does, and (3) How one feels in "the right place." DISCUSSION AND IMPLICATIONS Participants meanings' of AIRP are applied to Maslow's hierarchy of needs. That is, when basic needs of shelter are met, participants' considerations of "the right place to age" extend beyond affordable housing to include feeling safe and comfortable in one's home and neighborhood and having access to meaningful engagement and activities-both in vibrant urban districts and naturescapes-enabled by affordable transportation. Our examination of what AIRP means to this group of older adults broadens current conceptualizations. Given the increase in homelessness among older adults, it is imperative that policymakers and practitioners are cognizant of meanings of AIRP so diverse older adults can not only age in place, but can thrive in the right place.
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Affiliation(s)
- Sarah L Canham
- College of Social Work, University of Utah, Salt Lake City, Utah, USA
| | - Rachel Weldrick
- School of Urban and Regional Planning, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Atiya Mahmood
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Rachelle Patille
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada
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Hayward M, Helbich M. Environmental noise is positively associated with socioeconomically less privileged neighborhoods in the Netherlands. Environ Res 2024; 248:118294. [PMID: 38281559 DOI: 10.1016/j.envres.2024.118294] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/13/2024] [Accepted: 01/21/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Environmental noise has detrimental effects on various health outcomes. Although disparities in some environmental exposures (e.g., air pollution) are well-documented, there is still a limited and uncertain understanding of the extent to which specific populations are disproportionately burdened by noise. AIM To assess whether environmental noise levels are associated with demographic and socioeconomic neighborhood compositions. METHODS We cross-sectionally examined long-term noise levels for 9,372 neighborhoods in the Netherlands. We linked these noise levels with administrative data on neighborhood characteristics for the year 2021. Linear and non-linear spatial regression models were fitted to explore the associations between noise, demographic, and socioeconomic neighborhood characteristics. RESULTS Our results showed that 46 % of the neighborhoods exhibited noise levels surpassing the recommended threshold of 53 dB to prevent adverse health effects. The regressions uncovered positive and partially non-linear neighborhood-level associations between noise and non-Western migrants, employment rates, low-incomers, and address density. Conversely, we found negative associations with higher-educated neighborhoods and those with a greater proportion of younger residents. Neighborhoods with older populations displayed a U-shaped association. CONCLUSIONS This national study showed an inequality in the noise burden, adversely affecting vulnerable, marginalized, and less privileged neighborhoods. Addressing the uneven distribution of noise and its root causes is an urgent policy imperative for sustainable Dutch cities.
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Affiliation(s)
- Max Hayward
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 CB, Utrecht, the Netherlands
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Princetonlaan 8a, 3584 CB, Utrecht, the Netherlands.
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Lima da Silva JM, Oliveira JS, Casagrande Borges D, Honório OS, Mendes LL, Canuto R. Social inequities in food deserts and food swamps in a northeastern Brazilian capital. J Biosoc Sci 2024; 56:493-503. [PMID: 38415307 DOI: 10.1017/s0021932024000087] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
This study identified food deserts and swamps, investigating their associations with socioeconomic and demographic conditions. This ecological study was conducted using data from urban census tracts in the city of Recife, which were considered the unit of analysis. Information on food retail was obtained from government sources in 2019. Census tracts below the 25th percentile in the density of healthy food retail (i.e., those that predominantly sell natural or minimally processed foods, mixed businesses, and super- and hypermarkets) were classified as food deserts. Census tracts above the 25th percentile in the density of unhealthy food retail (i.e., those selling primarily ultra-processed foods) were considered food swamps. The socioeconomic and demographic conditions of the census tracts were evaluated using variables from the 2010 census (per capita income, average income, race, literacy of the head of household, and the availability of essential services) and the Health Vulnerability Index. Census tracts considered food deserts (28.5%) were more vulnerable, characterized by lower income and access to essential services, more illiterate residents and more minorities (Black/Indigenous/mixed race). Food swamps (73.47%) were more prevalent in less vulnerable neighbourhoods characterized by higher percentages of literate residents and Whites, greater purchasing power, and better basic sanitation. The characteristics of Recife's food deserts and swamps demonstrate social inequalities in the food environment. Public facilities could play a vital role in promoting healthy eating within food deserts. Additionally, future implementation of taxes on ultra-processed foods and the provision of tax subsidies to natural or minimally processed food sellers might contribute to fostering healthier dietary choices.
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Affiliation(s)
| | | | | | | | | | - Raquel Canuto
- Program in Nutrition, Universidade Federal de Pernambuco, Brazil
- Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Brazil
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Wolf ER, Richards A, Sabo RT, Woolf SH, Nelson BB, Krist AH. Neighborhood Predictors of Poor Prenatal Care and Well-Child Visit Attendance. Matern Child Health J 2024; 28:798-803. [PMID: 37991589 PMCID: PMC11001526 DOI: 10.1007/s10995-023-03844-9] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE Women and children continue to miss preventive visits. Which neighborhood factors predict inadequate prenatal care (PNC) and well-child visit (WCV) attendance remain unclear. DESCRIPTION In a retrospective case-control study at Virginia Commonwealth University Health System, mothers with less than 50% adherence or initiation after 5 months gestation were eligible as cases and those with ≥ 80% adherence and initiation before 5 months were eligible as controls. Children in the lowest quintile of adherence were eligible as cases and those with ≥ 80% of adherence were eligible as controls. Cases and controls were randomly selected at a 1:2 ratio and matched on birth month. Covariates were derived from the 2018 American Community Survey. A hotspot was defined as a zip code tabulation area (ZCTA) with a proportion of controls less than 0.66. ZCTAs with fewer than 5 individuals were excluded. Weighted quantile regression was used to determine which covariates were most associated with inadequate attendance. ASSESSMENT We identified 38 and 35 ZCTAs for the PNC and WCV analyses, respectively. Five of 11 hotspots for WCV were also hotspots for PNC. Education and income predicted 51% and 34% of the variation in missed PNCs, respectively; language, education and transportation difficulties explained 33%, 29%, and 17% of the variation in missed WCVs, respectively. Higher proportions of Black residents lived in hotspots of inadequate PCV and WCV attendance. CONCLUSION Neighborhood-level factors performed well in predicting inadequate PCV and WCV attendance. The disproportionate impact impact of inadequate PCV and WCV in neighborhoods where higher proportions of Black people lived highlights the potential influence of systemic racism and segregation on healthcare utilization.
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Affiliation(s)
- Elizabeth R Wolf
- Children's Hospital of Richmond at VCU, 1000 East Broad Street, Richmond, VA, 23219, USA.
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA.
| | - Alicia Richards
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Roy T Sabo
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | - Steven H Woolf
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
- Center on Society and Health, Richmond, VA, USA
| | - Bergen B Nelson
- Children's Hospital of Richmond at VCU, 1000 East Broad Street, Richmond, VA, 23219, USA
- Department of Pediatrics, Virginia Commonwealth University, Richmond, VA, USA
| | - Alex H Krist
- Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
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Matsumura Y, Yamamoto R, Shinzawa M, Otsuki N, Mizui M, Matsui I, Sakaguchi Y, Nishida M, Nakanishi K, Ide S, Ishibashi C, Kudo T, Yamauchi-Takihara K, Nagatomo I, Moriyama T. Living Arrangements Predict Frequent Alcohol Consumption Among University Students: A Retrospective Cohort Study. Am J Health Promot 2024; 38:478-482. [PMID: 38148141 DOI: 10.1177/08901171231224882] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
PURPOSE This study aimed to confirm the clinical impact of living arrangements on incidence of frequent alcohol consumption in university students. DESIGN A retrospective cohort study. SETTING A national university in Japan. SUBJECTS 17,774 university students. MEASURES The association between living arrangements on admission and the incidence of frequent alcohol consumption (≥4 days/week) was assessed using multivariable-adjusted Cox proportional-hazards models. RESULTS Among 5,685, 692, and 5,151 male students living with family, living in the dormitory, and living alone, 5.0%, 6.2%, and 5.8% reported frequent alcohol consumption during the median observational period of 3.0 years, respectively. Living in the dormitory and living alone were identified as significant predictors of frequent alcohol consumption (multivariable-adjusted hazard ratios: 1.00 [reference], 1.39 [1.01-1.92], and 1.21 [1.03-1.42], respectively). On the contrary, living arrangements were not associated with the incidence of frequent alcohol consumption among of 6,091 female students, partly because of low incidence of frequent alcohol consumption (2.3%, 1.4%, and 2.6%, respectively). CONCLUSIONS Living arrangements predicted frequent alcohol consumption among male university students, whereas not among female university students.
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Affiliation(s)
- Yuichiro Matsumura
- Laboratory of Behavioral Health Promotion, Department of Health Promotion Medicine, Graduate School of Medicine, Osaka University, Toyonaka, Japan
| | - Ryohei Yamamoto
- Laboratory of Behavioral Health Promotion, Department of Health Promotion Medicine, Graduate School of Medicine, Osaka University, Toyonaka, Japan
- Health and Counseling Center, Osaka University, Toyonaka, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Maki Shinzawa
- Health and Counseling Center, Osaka University, Toyonaka, Japan
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Naoko Otsuki
- Health and Counseling Center, Osaka University, Toyonaka, Japan
| | - Masayuki Mizui
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Isao Matsui
- Department of Nephrology, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yusuke Sakaguchi
- Department of Inter-Organ Communication Research in Kidney Diseases, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Makoto Nishida
- Health and Counseling Center, Osaka University, Toyonaka, Japan
| | - Kaori Nakanishi
- Health and Counseling Center, Osaka University, Toyonaka, Japan
| | - Seiko Ide
- Health and Counseling Center, Osaka University, Toyonaka, Japan
| | | | - Takashi Kudo
- Health and Counseling Center, Osaka University, Toyonaka, Japan
| | | | - Izumi Nagatomo
- Health and Counseling Center, Osaka University, Toyonaka, Japan
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15
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Lu SY, Yoon S, Yee WQ, Heng Wen Ngiam N, Ng KYY, Low LL. Experiences of a Community-Based Digital Intervention Among Older People Living in a Low-Income Neighborhood: Qualitative Study. JMIR Aging 2024; 7:e52292. [PMID: 38662423 DOI: 10.2196/52292] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 01/04/2024] [Accepted: 03/09/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Older adults worldwide experienced heightened risks of depression, anxiety, loneliness, and poor mental well-being during the COVID-19 pandemic. During this period, digital technology emerged as a means to mitigate social isolation and enhance social connectedness among older adults. However, older adults' behaviors and attitudes toward the adoption and use of digital technology are heterogeneous and shaped by factors such as age, income, and education. Few empirical studies have examined how older adults experiencing social and economic disadvantages perceive the learning of digital tools. OBJECTIVE This study aims to examine the motivations, experiences, and perceptions toward a community-based digital intervention among older adults residing in public rental flats in a low-income neighborhood. Specifically, we explored how their attitudes and behaviors toward learning the use of smartphones are shaped by their experiences related to age and socioeconomic challenges. METHODS This study adopted a qualitative methodology. Between December 2020 and March 2021, we conducted semistructured in-depth interviews with 19 participants aged ≥60 years who had completed the community-based digital intervention. We asked participants questions about the challenges encountered amid the pandemic, their perceived benefits of and difficulties with smartphone use, and their experiences with participating in the intervention. All interviews were audio recorded and analyzed using a reflexive thematic approach. RESULTS Although older learners stated varying levels of motivation to learn, most expressed ambivalence about the perceived utility and relevance of the smartphone to their current needs and priorities. While participants valued the social interaction with volunteers and the personalized learning model of the digital intervention, they also articulated barriers such as age-related cognitive and physical limitations and language and illiteracy that hindered their sustained use of these digital devices. Most importantly, the internalization of ageist stereotypes of being less worthy learners and the perception of smartphone use as being in the realm of the privileged other further reduced self-efficacy and interest in learning. CONCLUSIONS To improve learning and sustained use of smartphones for older adults with low income, it is essential to explore avenues that render digital tools pertinent to their daily lives, such as creating opportunities for social connections and relationship building. Future studies should investigate the relationships between older adults' social, economic, and health marginality and their ability to access digital technologies. We recommend that the design and implementation of digital interventions should prioritize catering to the needs and preferences of various segments of older adults, while working to bridge rather than perpetuate the digital divide.
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Affiliation(s)
- Si Yinn Lu
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Sungwon Yoon
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Center for Population Health Research and Implementation, SingHealth, Regional Health System, Singapore, Singapore
| | - Wan Qi Yee
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
| | - Nerice Heng Wen Ngiam
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- Department of Internal Medicine, Singapore General Hospital, Singapore, Singapore
- TriGen Ltd, Singapore, Singapore
| | - Kennedy Yao Yi Ng
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- TriGen Ltd, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
| | - Lian Leng Low
- Center for Population Health Research and Implementation, SingHealth, Regional Health System, Singapore, Singapore
- Population Health and Integrated Care Office, Singapore General Hospital, Singapore, Singapore
- SingHealth Duke-NUS Family Medicine Academic Clinical Program, Duke-NUS Medical School, Singapore, Singapore
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16
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Lin B, Middleton RR, Terefe B, Appleton AA, Feingold BJ, Lynch T, Pieterse AL, Rogers R, Armah AE, Bierce LF, Flagg AM, McCarthy S. The Birth and Beyond (BABY) study: protocol for a birth cohort study investigating the social and environmental determinants of pregnancy-related outcomes in Black American families. BMJ Open 2024; 14:e087141. [PMID: 38658013 DOI: 10.1136/bmjopen-2024-087141] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
INTRODUCTION In the USA, Black birthing people and infants experience disproportionately worse pregnancy-related health outcomes. The causes for these disparities are unknown, but evidence suggests that they are likely socially and environmentally based. Efforts to identify the determinants of these racial disparities are urgently needed to elucidate the highest priority targets for intervention. The Birth and Beyond (BABY) study evaluates how micro-level (eg, interpersonal and family) and macro-level (eg, neighbourhood and environmental) risk and resiliency factors transact to shape birth person-infant health, and underlying psychobiological mechanisms. METHODS AND ANALYSIS The BABY study will follow 350 Black families (birthing parents, non-birthing parents and infants) from pregnancy through the first postpartum year, with research visits during pregnancy and at infant ages 6 and 12 months. Research visits comprise a combination of interview about a range of recent and life course stress and resiliency exposures and supports, psychophysiological (sympathetic, parasympathetic and adrenocortical) assessment and behavioural observations of parent-infant coregulatory behaviours. Spatial analyses are completed by mapping parent current and past residential addresses onto archival public data (eg, about neighbourhood quality and racial segregation). Finally, EMRs are abstracted for information about birthing parent relevant medical history, pregnancy conditions and infant birth outcomes. Analyses will evaluate the risk and resiliency mechanisms that contribute to pregnancy and birth-related outcomes for Black birthing people and their infants, and the protective role of individual, familial, cultural, and community supports. ETHICS AND DISSEMINATION The BABY study has been approved by the Institutional Review Board at Albany Medical Centre. The study team consulted with local organisations and groups comprised of stakeholders and community leaders and continues to do so throughout the study. Research results will be disseminated with the scientific and local community as appropriate.
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Affiliation(s)
- Betty Lin
- Department of Psychology, College of Arts and Sciences, University at Albany, Albany, New York, USA
- Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
| | - Rachel R Middleton
- Department of Psychology, College of Arts and Sciences, University at Albany, Albany, New York, USA
| | - Bethlehem Terefe
- Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
| | - Allison A Appleton
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Albany, New York, USA
| | - Beth J Feingold
- Department of Environmental Health Sciences, School of Public Health, University at Albany, Albany, New York, USA
| | - Tara Lynch
- Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
| | - Alex L Pieterse
- Department of Counseling, Educational and Developmental Psychology, Boston College Carolyn A and Peter S Lynch School of Education and Human Development, Chestnut Hill, Massachusetts, USA
| | - Rebecca Rogers
- Obstetrics and Gynecology, Albany Medical Center, Albany, New York, USA
| | - Annabelle E Armah
- Department of Psychology, College of Arts and Sciences, University at Albany, Albany, New York, USA
| | - Lydia F Bierce
- Department of Psychology, College of Arts and Sciences, University at Albany, Albany, New York, USA
| | - Amanda M Flagg
- Department of Psychology, College of Arts and Sciences, University at Albany, Albany, New York, USA
| | - Sarah McCarthy
- Department of Sociology, University at Albany College of Arts and Sciences, Albany, New York, USA
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17
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Oh JI, Lee KJ, Hipp A. Food deserts exposure, density of fast-food restaurants, and park access: Exploring the association of food and recreation environments with obesity and diabetes using global and local regression models. PLoS One 2024; 19:e0301121. [PMID: 38635494 PMCID: PMC11025848 DOI: 10.1371/journal.pone.0301121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 03/11/2024] [Indexed: 04/20/2024] Open
Abstract
To prevent obesity and diabetes environmental interventions such as eliminating food deserts, restricting proliferation of food swamps, and improving park access are essential. In the United States, however, studies that examine the food and park access relationship with obesity and diabetes using both global and local regression are lacking. To guide county, state, and federal policy in combating obesity and diabetes, there is a need for cross-scale analyses to identify that relationship at national and local levels. This study applied spatial regression and geographically weighted regression to the 3,108 counties in the contiguous United States. Global regression show food deserts exposure and density of fast-food restaurants have non-significant association with obesity and diabetes while park access has a significant inverse association with both diseases. Geographically weighted regression that takes into account spatial heterogeneity shows that, among southern states that show high prevalence of obesity and diabetes, Alabama and Mississippi stand out as having opportunity to improve park access. Results suggest food deserts exposure are positively associated with obesity and diabetes in counties close to Alabama, Georgia, and Tennessee while density of fast-food restaurants show positive association with two diseases in counties of western New York and northwestern Pennsylvania. These findings will help policymakers and public health agencies in determining which geographic areas need to be prioritized when implementing public interventions such as promoting healthy food access, limiting unhealthy food options, and increasing park access.
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Affiliation(s)
- Jae In Oh
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
| | - KangJae Jerry Lee
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
- Department of Parks, Recreation & Tourism, University of Utah, Salt Lake City, Utah, United States of America
| | - Aaron Hipp
- Department of Parks, Recreation & Tourism Management, North Carolina State University, Raleigh, North Carolina, United States of America
- Center for Geospatial Analytics, North Carolina State University, Raleigh, North Carolina, United States of America
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18
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Bartoll-Roca X, López MJ, Pérez K, Artazcoz L, Borrell C. Short-term health effects of an urban regeneration programme in deprived neighbourhoods of Barcelona. PLoS One 2024; 19:e0300470. [PMID: 38630702 PMCID: PMC11023398 DOI: 10.1371/journal.pone.0300470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 02/27/2024] [Indexed: 04/19/2024] Open
Abstract
Urban regeneration programmes are interventions meant to enhance the wellbeing of residents in deprived areas, although empirical evidence reports mixed results. We evaluated the health impact of a participatory and neighbourhood-wide urban regeneration programme, Pla de Barris 2016-2020, in Barcelona. A pre-post with a comparison group study design. Using data from a cross-sectional survey performed in 2016 and 2021. The health outcomes analysed were mental health, alcohol and psychotropic drug use, perceived health status, physical activity and obesity. Depending on the investment, two intervention groups were defined: moderate- and high-intensity intervention groups. The analysis combined difference-in-difference estimation with an inverse weighting derived from a propensity score to reduce potential biases. The impact of the intervention in percentages and its confidence interval were estimated with a linear probability model with clustered adjusted errors. The intervention had a positive impact on health outcomes in women in the high-intensity intervention group: a reduction of 15.5% in the relative frequency of those experiencing poor mental health, and of 21.7% in the relative frequency of those with poor self-perceived health; and an increase of 13.7% in the relative frequency of those doing physical activity. No positive impact was observed for men, but an increase of 10.3% in the relative frequency of those using psychotropic drugs in the high-intensity intervention group. This study shows positive short-term effects of the urban regeneration programme Pla de Barris 2016-2020 on health outcomes in women in the high-intensity intervention group. These results can guide future interventions in other areas.
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Affiliation(s)
- Xavier Bartoll-Roca
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
| | - María José López
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Katherine Pérez
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
| | - Lucía Artazcoz
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Universitat Pompeu Fabra, Barcelona, Spain
| | - Carme Borrell
- Agència de Salut Pública de Barcelona (ASPB), Barcelona, Catalunya, Spain
- Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Spain
- Universitat Pompeu Fabra, Barcelona, Spain
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19
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Wende ME, Hughey SM, McLain AC, Hallum S, Hipp JA, Schipperijn J, Stowe EW, Kaczynski AT. Identifying multilevel predictors of behavioral outcomes like park use: A comparison of conditional and marginal modeling approaches. PLoS One 2024; 19:e0301549. [PMID: 38626162 PMCID: PMC11020402 DOI: 10.1371/journal.pone.0301549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/18/2024] [Indexed: 04/18/2024] Open
Abstract
This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial composition, walkability) levels. Generalized linear mixed models and generalized estimating equations were used. Ten-fold cross validation compared predictive performance of models. Conditional and marginal models identified common park use predictors: participant race, participant education, distance to parks, park quality, and population >65yrs. Additionally, the conditional mode identified park size as a park use predictor. The conditional model exhibited superior predictive value compared to the marginal model, and they exhibited similar generalizability. Future research should consider conditional and marginal approaches for analyzing health behavior data and employ cross-validation techniques to identify instances where marginal models display superior or comparable performance.
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Affiliation(s)
- Marilyn E. Wende
- Department of Health Education & Behavior, College of Health & Human Performance, University of Florida, Gainesville, FL, United States of America
| | - S. Morgan Hughey
- Department of Health and Human Performance, School of Health Sciences, College of Charleston, Charleston, SC, United States of America
| | - Alexander C. McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Shirelle Hallum
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - J. Aaron Hipp
- Department of Parks, Recreation, and Tourism Management, Center for Geospatial Analytics, North Carolina State University, Raleigh, NC, United States of America
| | - Jasper Schipperijn
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ellen W. Stowe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
| | - Andrew T. Kaczynski
- Department of Health Promotion, Education, and Behavior, Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States of America
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Wang ML, Gago CM, Rodriguez K. Digital Redlining-The Invisible Structural Determinant of Health. JAMA 2024; 331:1267-1268. [PMID: 38497952 DOI: 10.1001/jama.2024.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/19/2024]
Abstract
This Viewpoint describes digital redlining as racialized inequities in access to technology infrastructure, including access to health care, education, employment, and social services.
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Affiliation(s)
- Monica L Wang
- Boston University School of Public Health, Department of Community Health Sciences, Boston, Massachusetts
- Harvard T.H. Chan School of Public Health, Department of Health Policy and Management, Boston, Massachusetts
| | - Cristina M Gago
- Boston University School of Public Health, Department of Community Health Sciences, Boston, Massachusetts
| | - Kate Rodriguez
- Boston University School of Public Health, Department of Community Health Sciences, Boston, Massachusetts
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21
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Fields ND, Tristan Urrutia A, Morris AA, Kramer MR, Lewis TT, Patel SA. Historical Redlining and Heart Failure Outcomes Following Hospitalization in the Southeastern United States. J Am Heart Assoc 2024; 13:e032019. [PMID: 38563370 DOI: 10.1161/jaha.123.032019] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 03/12/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND Historical redlining, a discriminatory lending practice, is an understudied component of the patient risk environment following hospital discharge. We investigated associations between redlining, patient race, and outcomes following heart failure hospitalization. METHODS AND RESULTS We followed a hospital-based cohort of Black and White patients using electronic medical records for acute heart failure hospitalizations between 2010 and 2018 (n=6800). Patient residential census tracts were geocoded according to the 1930s Home Owners' Loan Corporation map grades (A/B: best/still desirable, C: declining, D: redlined). We used Poisson regression to analyze associations between Home Owners' Loan Corporation grade and 30-day outcomes (readmissions, mortality, and their composite). One-third of patients resided in historically redlined tracts (n=2034). In race-stratified analyses, there was a positive association between historically declining neighborhoods and composite readmissions and mortality for Black patients (risk ratio [RR], 1.24 [95% CI, 1.003-1.54]) and an inverse association between redlined neighborhoods and 30-day readmissions among White patients (RR, 0.58 [95% CI, 0.39-0.86]). Examining racial disparities across Home Owners' Loan Corporation grades, Black patients had higher 30-day readmissions (RR, 1.86 [95% CI, 1.31-2.65]) and composite readmissions and mortality (RR, 1.32 [95% CI, 1.04-1.65]) only in historically redlined neighborhoods. CONCLUSIONS Historical redlining had potentially mixed impacts on outcomes by race, such that residing in less desirable neighborhoods was associated with an elevated risk of an adverse outcome following heart failure hospitalization in Black patients and a reduced risk in White patients. Moreover, racial disparities in patient outcomes were present only in historically redlined neighborhoods. Additional research is needed to explore observed heterogeneity in outcomes.
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Affiliation(s)
- Nicole D Fields
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA USA
- Hubert Department of Global Health Rollins School of Public Health Emory University Atlanta GA USA
| | - Andrea Tristan Urrutia
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA USA
| | | | - Michael R Kramer
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA USA
| | - Tené T Lewis
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA USA
| | - Shivani A Patel
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA USA
- Hubert Department of Global Health Rollins School of Public Health Emory University Atlanta GA USA
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22
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Koops-Van Hoffen HE, Vendrig-De Punder YMR, Van Lenthe FJ, Borlée F, Jambroes M, Kamphuis CBM. Health effects of holistic housing renovation in a disadvantaged neighbourhood in the Netherlands: a qualitative exploration among residents and professionals. BMC Public Health 2024; 24:1056. [PMID: 38622675 PMCID: PMC11020185 DOI: 10.1186/s12889-024-18500-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND Holistic housing renovations combine physical housing improvements with social and socioeconomic interventions (e.g. referral to social services, debt counselling, involvement in decision-making, promoting social cohesion). In a deprived neighbourhood in Utrecht, the Netherlands, this paper examined residents' and professionals' experiences, ideas, and perceptions regarding holistic housing renovation, its health effects, and underlying mechanisms explaining those effects. METHODS Semi-structured in-depth interviews were conducted with 21 social housing residents exposed to holistic housing renovation, and 12 professionals involved in either the physical renovation or social interventions implemented. Residents were interviewed in various renovation stages (before, during, after renovation). Transcripts were deductively and inductively coded using qualitative software. RESULTS Residents experienced and professionals acknowledged renovation stress caused by nuisance from construction work (noise, dust), having to move stuff around, and temporary moving; lack of information and control; and perceived violation of privacy. Involvement in design choices was appreciated, and mental health improvement was expected on the long term due to improved housing quality and visual amenity benefits. Social contact between residents increased as the renovation became topic for small talk. Few comments were made regarding physical health effects. The interviews revealed a certain amount of distrust in and dissatisfaction with the housing corporation, construction company, and other authorities. CONCLUSIONS Renovation stress, aggravated by lack of information and poor accessibility of housing corporation and construction company, negatively affects mental health and sense of control. Potential stress relievers are practical help with packing and moving furniture, and increased predictability by good and targeted communication. Social interventions can best be offered after renovation, when residents live in their renovated apartment and the nuisance and stress from the renovation is behind them. Social partners can use the period leading up to the renovation to show their faces, offer practical help to reduce renovation stress, and increase residents' trust in their organization and authorities in general. This might also contribute to residents' willingness to accept help with problems in the social domain after renovation.
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Affiliation(s)
- H E Koops-Van Hoffen
- Department of Human Geography and Spatial Planning, Utrecht University, P.O. 80.115, Utrecht, 3508 TC, the Netherlands.
| | - Y M R Vendrig-De Punder
- Department of Global Public Health & Bioethics, Julius Center, University Medical Center Utrecht, Huispostnummer Str. 6.131, P.O. 85500, Utrecht, 3508 GA, the Netherlands
| | - F J Van Lenthe
- Department of Human Geography and Spatial Planning, Utrecht University, P.O. 80.115, Utrecht, 3508 TC, the Netherlands
- Department of Public Health, Erasmus MC University Medical Center Rotterdam, P.O. 2040, Rotterdam, 3000 CA, the Netherlands
| | - F Borlée
- Department of Public Health, Municipality of Utrecht, P.O. 16200, Utrecht, 3500 CE, the Netherlands
| | - M Jambroes
- Department of Global Public Health & Bioethics, Julius Center, University Medical Center Utrecht, Huispostnummer Str. 6.131, P.O. 85500, Utrecht, 3508 GA, the Netherlands
| | - C B M Kamphuis
- Department of Interdisciplinary Social Science, Utrecht University, P.O. 80140, Utrecht, 3584 CH, the Netherlands
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Durst NJ, Sullivan E, Jochem WC. The spatial and social correlates of neighborhood morphology: Evidence from building footprints in five U.S. metropolitan areas. PLoS One 2024; 19:e0299713. [PMID: 38598463 PMCID: PMC11006153 DOI: 10.1371/journal.pone.0299713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 02/13/2024] [Indexed: 04/12/2024] Open
Abstract
Recent advances in quantitative tools for examining urban morphology enable the development of morphometrics that can characterize the size, shape, and placement of buildings; the relationships between them; and their association with broader patterns of development. Although these methods have the potential to provide substantial insight into the ways in which neighborhood morphology shapes the socioeconomic and demographic characteristics of neighborhoods and communities, this question is largely unexplored. Using building footprints in five of the ten largest U.S. metropolitan areas (Atlanta, Boston, Chicago, Houston, and Los Angeles) and the open-source R package, foot, we examine how neighborhood morphology differs across U.S. metropolitan areas and across the urban-exurban landscape. Principal components analysis, unsupervised classification (K-means), and Ordinary Least Squares regression analysis are used to develop a morphological typology of neighborhoods and to examine its association with the spatial, socioeconomic, and demographic characteristics of census tracts. Our findings illustrate substantial variation in the morphology of neighborhoods, both across the five metropolitan areas as well as between central cities, suburbs, and the urban fringe within each metropolitan area. We identify five different types of neighborhoods indicative of different stages of development and distributed unevenly across the urban landscape: these include low-density neighborhoods on the urban fringe; mixed use and high-density residential areas in central cities; and uniform residential neighborhoods in suburban cities. Results from regression analysis illustrate that the prevalence of each of these forms is closely associated with variation in socioeconomic and demographic characteristics such as population density, the prevalence of multifamily housing, and income, race/ethnicity, homeownership, and commuting by car. We conclude by discussing the implications of our findings and suggesting avenues for future research on neighborhood morphology, including ways that it might provide insight into issues such as zoning and land use, housing policy, and residential segregation.
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Affiliation(s)
- Noah J. Durst
- Noah J. Durst, School of Planning, Design and Construction, Michigan State University, East Lansing, MI, United States of America
| | - Esther Sullivan
- Esther Sullivan, Department of Sociology, University of Colorado Denver, Denver, CO, United States of America
| | - Warren C. Jochem
- Warren C. Jochem, School of Geography and Environmental Science, University of Southampton, Southampton, United Kingdom
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Ruano A, Ruano MDG. From home energy management systems to energy communities: methods and data. Sci Data 2024; 11:346. [PMID: 38582775 PMCID: PMC10998857 DOI: 10.1038/s41597-024-03184-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 03/25/2024] [Indexed: 04/08/2024] Open
Abstract
This paper introduces the HEMStoEC database, which contains data recorded in the course of two research projects, NILMforIHEM , and HEMS2IEA , for more than three years. To be manageable, the dataset is divided in months, from January 2020 until February 2023. It consists in: (a) consumption electric data for four houses in a neighbourhood situated in the south of Portugal, (b) weather data for that location, (c) photovoltaic and battery data, (d) inside climate data, and (e) operation of several electric devices in one of the four houses. Raw data, sampled at 1 sec and 1 minute are available from the different sensing devices, as well as synchronous data, with a common sampling interval of 5 minutes are available. Gaps existing within the data, as well as periods where interpolation was used, are available for each month of data.
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Affiliation(s)
- Antonio Ruano
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, and Faculty of Science & Technology, University of Algarve, Faro, Portugal.
| | - Maria da Graça Ruano
- CISUC, University of Coimbra, Coimbra, and Faculty of Science & Technology, University of Algarve, Faro, Portugal
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25
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Hayes S, Duan KI, Wai TH, Picazo F, Donovan LM, Spece LJ, Plumley R, Slatore CG, Thakur N, Crothers K, Au DH, Feemster LC. Association between Neighborhood Socioeconomic Disadvantage and Chronic Obstructive Pulmonary Disease Prevalence Among U.S. Veterans. Ann Am Thorac Soc 2024; 21:669-672. [PMID: 38252425 PMCID: PMC10995553 DOI: 10.1513/annalsats.202308-668rl] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 01/19/2024] [Indexed: 01/23/2024] Open
Affiliation(s)
- Sophia Hayes
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
| | - Kevin I. Duan
- University of WashingtonSeattle, Washington
- University of British ColumbiaVancouver, British Columbia, Canada
| | | | - Fernando Picazo
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
| | - Lucas M. Donovan
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
| | - Laura J. Spece
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
| | | | - Christopher G. Slatore
- VA Portland Health Care SystemPortland, Oregon
- Oregon Health and Science UniversityPortland, Oregon
| | - Neeta Thakur
- University of California, San FranciscoSan Francisco, California
| | - Kristina Crothers
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
| | - David H. Au
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
- Department of Veterans AffairsWashington, DC
| | - Laura C. Feemster
- VA Puget Sound Health Care SystemSeattle, Washington
- University of WashingtonSeattle, Washington
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26
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Ramírez-Toscano Y, Skaba D, de Matos VP, Pérez-Ferrer C, Barrientos-Gutiérrez T, López-Olmedo N, Pina MDF. Agreement between a web collaborative dataset and an administrative dataset to assess the retail food environment in Mexico. BMC Public Health 2024; 24:930. [PMID: 38556871 PMCID: PMC10983718 DOI: 10.1186/s12889-024-18410-3] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 03/21/2024] [Indexed: 04/02/2024] Open
Abstract
BACKGROUND Latin American countries are often limited in the availability of food outlet data. There is a need to use online search engines that allow the identification of food outlets and assess their agreement with field observations. We aimed to assess the agreement in the density of food outlets provided by a web collaborative data (Google) against the density obtained from an administrative registry. We also determined whether the agreement differed by type of food outlet and by area-level socioeconomic deprivation. METHODS In this cross-sectional study, we analyzed 1,693 census tracts from the municipalities of Hermosillo, Leon, Oaxaca de Juarez, and Tlalpan. The Google service was used to develop a tool for the automatic acquisition of food outlet data. To assess agreement, we compared food outlet densities obtained with Google against those registered in the National Statistical Directory of Economic Units (DENUE). Continuous densities were assessed using Bland-Altman plots and concordance correlation coefficient (CCC), while agreement across tertiles of density was estimated using weighted kappa. RESULTS The CCC indicated a strong correlation between Google and DENUE in the overall sample (0.75); by food outlet, most of the correlations were from negligible (0.08) to moderate (0.58). The CCC showed a weaker correlation as deprivation increased. Weighted kappa indicated substantial agreement between Google and DENUE across all census tracts (0.64). By type of food outlet, the weighted kappa showed substantial agreement for restaurants (0.69) and specialty food stores (0.68); the agreement was moderate for convenience stores/small food retail stores (0.49) and fair for candy/ice cream stores (0.30). Weighted kappa indicated substantial agreement in low-deprivation areas (0.63); in very high-deprivation areas, the agreement was moderate (0.42). CONCLUSIONS Google could be useful in assessing fixed food outlet densities as a categorical indicator, especially for some establishments, like specialty food stores and restaurants. The data could also be informative of the availability of fixed food outlets, particularly in less deprived areas.
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Affiliation(s)
- Yenisei Ramírez-Toscano
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP, 62100, Mexico
| | - Daniel Skaba
- Instituto de Comunicação E Informação Científica E Tecnológica Em Saúde / Fundação Oswaldo Cruz - ICICT/FIOCRUZ, Rio de Janeiro, Brazil
| | - Vanderlei Pascoal de Matos
- Instituto de Comunicação E Informação Científica E Tecnológica Em Saúde / Fundação Oswaldo Cruz - ICICT/FIOCRUZ, Rio de Janeiro, Brazil
| | - Carolina Pérez-Ferrer
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP, 62100, Mexico
| | - Tonatiuh Barrientos-Gutiérrez
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP, 62100, Mexico
| | - Nancy López-Olmedo
- Center for Population Health Research, National Institute of Public Health, Avenida Universidad 655, Santa María Ahuacatitlán, Cuernavaca, Morelos CP, 62100, Mexico.
| | - Maria de Fátima Pina
- Instituto de Comunicação E Informação Científica E Tecnológica Em Saúde / Fundação Oswaldo Cruz - ICICT/FIOCRUZ, Rio de Janeiro, Brazil.
- Instituto de Investigação E Inovação Em Saúde Universidade Do Porto, Porto, Portugal.
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27
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Brokamp C, Jones MN, Duan Q, Rasnick Manning E, Ray S, Corley AMS, Michael J, Taylor S, Unaka N, Beck AF. Causal Mediation of Neighborhood-Level Pediatric Hospitalization Inequities. Pediatrics 2024; 153:e2023064432. [PMID: 38426267 DOI: 10.1542/peds.2023-064432] [Citation(s) in RCA: 0] [Impact Index Per Article: 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] [Accepted: 01/18/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Population-wide racial inequities in child health outcomes are well documented. Less is known about causal pathways linking inequities and social, economic, and environmental exposures. Here, we sought to estimate the total inequities in population-level hospitalization rates and determine how much is mediated by place-based exposures and community characteristics. METHODS We employed a population-wide, neighborhood-level study that included youth <18 years hospitalized between July 1, 2016 and June 30, 2022. We defined a causal directed acyclic graph a priori to estimate the mediating pathways by which marginalized population composition causes census tract-level hospitalization rates. We used negative binomial regression models to estimate hospitalization rate inequities and how much of these inequities were mediated indirectly through place-based social, economic, and environmental exposures. RESULTS We analyzed 50 719 hospitalizations experienced by 28 390 patients. We calculated census tract-level hospitalization rates per 1000 children, which ranged from 10.9 to 143.0 (median 45.1; interquartile range 34.5 to 60.1) across included tracts. For every 10% increase in the marginalized population, the tract-level hospitalization rate increased by 6.2% (95% confidence interval: 4.5 to 8.0). After adjustment for tract-level community material deprivation, crime risk, English usage, housing tenure, family composition, hospital access, greenspace, traffic-related air pollution, and housing conditions, no inequity remained (0.2%, 95% confidence interval: -2.2 to 2.7). Results differed when considering subsets of asthma, type 1 diabetes, sickle cell anemia, and psychiatric disorders. CONCLUSIONS Our findings provide additional evidence supporting structural racism as a significant root cause of inequities in child health outcomes, including outcomes at the population level.
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Affiliation(s)
- Cole Brokamp
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Margaret N Jones
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Qing Duan
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | | | - Sarah Ray
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Alexandra M S Corley
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Joseph Michael
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Stuart Taylor
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Ndidi Unaka
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Andrew F Beck
- Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
- University of Cincinnati College of Medicine, Cincinnati, Ohio
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28
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Kranjac AW, Kranjac D, Kain ZN, Ehwerhemuepha L, Jenkins BN. Obesity Heterogeneity by Neighborhood Context in a Largely Latinx Sample. J Racial Ethn Health Disparities 2024; 11:980-991. [PMID: 36997832 PMCID: PMC10933170 DOI: 10.1007/s40615-023-01578-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/27/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
Neighborhood socioeconomic context where Latinx children live may influence body weight status. Los Angeles County and Orange County of Southern California both are on the list of the top ten counties with the largest Latinx population in the USA. This heterogeneity allowed us to estimate differential impacts of neighborhood environment on children's body mass index z-scores by race/ethnicity using novel methods and a rich data source. We geocoded pediatric electronic medical record data from a predominantly Latinx sample and characterized neighborhoods into unique residential contexts using latent profile modeling techniques. We estimated multilevel linear regression models that adjust for comorbid conditions and found that a child's place of residence independently associates with higher body mass index z-scores. Interactions further reveal that Latinx children living in Middle-Class neighborhoods have higher BMI z-scores than Asian and Other Race children residing in the most disadvantaged communities. Our findings underscore the complex relationship between community racial/ethnic composition and neighborhood socioeconomic context on body weight status during childhood.
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Affiliation(s)
- Ashley W Kranjac
- Department of Sociology, Chapman University, Orange, CA, USA
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
| | - Dinko Kranjac
- Department of Psychology, Institute for Mental Health and Psychological Well-Being, University of La Verne, La Verne, CA, USA
| | - Zeev N Kain
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA
- Yale Child Study Center, Yale University, New Haven, CT, USA
| | | | - Brooke N Jenkins
- Center for Stress & Health, University of California School of Medicine, Irvine, CA, USA.
- Department of Anesthesiology and Perioperative Care, University of California, Irvine, CA, USA.
- Department of Psychology, Chapman University, One University Drive, Orange, CA, 92866, USA.
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29
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Rummo PE, Kanchi R, Adhikari S, Titus AR, Lee DC, McAlexander T, Thorpe LE, Elbel B. Influence of the food environment on obesity risk in a large cohort of US veterans by community type. Obesity (Silver Spring) 2024; 32:788-797. [PMID: 38298108 DOI: 10.1002/oby.23975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/30/2023] [Accepted: 12/01/2023] [Indexed: 02/02/2024]
Abstract
OBJECTIVE The aim of this study was to examine relationships between the food environment and obesity by community type. METHODS Using electronic health record data from the US Veterans Administration Diabetes Risk (VADR) cohort, we examined associations between the percentage of supermarkets and fast-food restaurants with obesity prevalence from 2008 to 2018. We constructed multivariable logistic regression models with random effects and interaction terms for year and food environment variables. We stratified models by community type. RESULTS Mean age at baseline was 59.8 (SD = 16.1) years; 93.3% identified as men; and 2,102,542 (41.8%) were classified as having obesity. The association between the percentage of fast-food restaurants and obesity was positive in high-density urban areas (odds ratio [OR] = 1.033; 95% CI: 1.028-1.037), with no interaction by time (p = 0.83). The interaction with year was significant in other community types (p < 0.001), with increasing odds of obesity in each follow-up year. The associations between the percentage of supermarkets and obesity were null in high-density and low-density urban areas and positive in suburban (OR = 1.033; 95% CI: 1.027-1.039) and rural (OR = 1.007; 95% CI: 1.002-1.012) areas, with no interactions by time. CONCLUSIONS Many healthy eating policies have been passed in urban areas; our results suggest such policies might also mitigate obesity risk in nonurban areas.
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Affiliation(s)
- Pasquale E Rummo
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Rania Kanchi
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Samrachana Adhikari
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Andrea R Titus
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - David C Lee
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Emergency Medicine, NYU Langone Health, New York, New York, USA
| | - Tara McAlexander
- Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Lorna E Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Brian Elbel
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- NYU Wagner Graduate School of Public Service, New York, New York, USA
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30
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Schober DJ, Wolf A, Castro MC, Slezak J, Hastings P, Latiker D. An Academic-Community Partnership to Address Gun Violence in the Roseland Neighborhood of Chicago. Fam Community Health 2024; 47:141-150. [PMID: 38372331 DOI: 10.1097/fch.0000000000000392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
BACKGROUND AND OBJECTIVES Gun violence is the leading cause of death for youth. This study examined an academic-community partnership to address gun violence through a strength-based approach called Asset-Based Community Development. METHODS We used a case study design. Participants were Black youth who encounter frequent gun violence (average age = 16.7 years; 72% male). Our partnership involved survey development/completion and semistructured discussions. We also interviewed community stakeholders to collect data on local assets. We interpreted data through a communitywide forum to guide social action to address gun violence. RESULTS The majority of youth (76%) witnessed neighborhood violence in the last year. The top youth concerns related to gun violence included poverty, guns, and gangs. Community stakeholders saw local people and local organizations as primary community assets. A community forum to interpret these data led to social action in the form of an environmental strategy-cleaning up an unused commercial building for the development of a youth tech center. The majority of youth participants (89.5%) agreed or strongly agreed that they had a voice in the research process. CONCLUSION Participatory research that takes an asset-based approach can enable relevant inquiry that engages youth and guides social action to address gun violence.
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Affiliation(s)
- Daniel J Schober
- Public Health Program, DePaul University, Chicago, Illinois (Dr Schober); Pediatric Critical Care, UChicago Medicine, Chicago, Illinois (Dr Wolf); Sinai Chicago: Sinai Urban Health Institute, Chicago, Illinois (Mr Castro); School of Public Health, Loyola University, Maywood, Illinois (Ms Slezak); Clinical Psychology, Adler University, Chicago, Illinois (Ms Hastings); and Kids Off The Block, Chicago, Illinois (Ms Latiker)
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31
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Li X, Jansåker F, Sundquist J, Sundquist K. Neighbourhood deprivation and type 2 diabetes in patients with bipolar disorder: A nationwide follow-up study. Stress Health 2024; 40:e3302. [PMID: 37565544 DOI: 10.1002/smi.3302] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 05/18/2023] [Accepted: 07/27/2023] [Indexed: 08/12/2023]
Abstract
Patients with bipolar disorder have higher rates of type 2 diabetes (T2D) compared to the general population. Neighbourhood deprivation is associated with T2D and bipolar disorder. The aim of this study was to explore the potential effect of neighbourhood deprivation on incident T2D in patients with bipolar disorder. This nationwide open cohort study (1997-2018) included adults in Sweden ≥20 years with bipolar disorder (90,780 patients) to examine the subsequent risk of T2D. The association between neighbourhood deprivation and T2D was explored using Cox regression analysis, with hazard ratios (HRs) and 95% confidence intervals (95% CIs). All models were conducted in both men and women and adjusted for individual-level sociodemographic factors and comorbidities. Neighbourhood deprivation was significantly associated with T2D in patients with bipolar disorder. The HRs were 1.61 (95% CI 1.40-1.86) for men and 1.83 (1.60-2.10) for women living in high deprivation neighbourhoods compared to those from low deprivation neighbourhoods. After adjustment, these results remained significant: 1.35 (1.17-1.56) in men and 1.39 (1.20-1.60) in women living in high deprivation neighbourhoods. The suggested graded association of higher incident T2D among patients with bipolar disorder, observed when levels of neighbourhood deprivation increased, raises important clinical and public health concerns. The results may help develop a contextual approach to prevention of T2D in patients with bipolar disorder that includes the neighbourhood environment.
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Affiliation(s)
- Xinjun Li
- Center for Primary Health Care Research, Lund University, Lund, Sweden
| | - Filip Jansåker
- Center for Primary Health Care Research, Lund University, Lund, Sweden
- Department of Clinical Microbiology, Center of Diagnostic Investigations, Copenhagen University Hospital, Rigshospitalet, Denmark
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Lund, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Lund, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue, Japan
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32
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Lichter DT, Parisi D, Ambinakudige S, Scott CK. Reevaluating the Spatial Scale of Residential Segregation: Racial Change Within and Between Neighborhoods. Demography 2024; 61:307-336. [PMID: 38394036 DOI: 10.1215/00703370-11195639] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
This study evaluates the extent to which metropolitan racial segregation occurs between neighborhoods-from tract to tract-and within neighborhoods-from block to block-and is framed theoretically by Putnam's (2007) "hunkering down" hypothesis. Analyses are based on complete-count block, tract, and metropolitan data from the last four U.S. decennial censuses. We document recent patterns of block-to-block segregation between Whites and racial and ethnic minorities (Blacks, Asians, and Hispanics) and between different minority pairs. For example, roughly 40% of all metro Black-White segregation is due to segregation from block to block within neighborhoods. Among Asians, the between-neighborhood component of metropolitan segregation has increased over time but was largely compensated by declines in the within-neighborhood (or block) component. Metropolitan fixed-effects models show that trends and racial and ethnic differences in segregation-overall and within and between neighborhoods-are broadly observed across metro areas but are most evident in the largest, oldest, and most highly segregated metro areas. The results are robust to alternative estimates that adjust for differential privacy, metropolitan reclassification, and neighborhood boundary changes. Analyses of neighborhood change in Atlanta, Georgia, further reinforce the generality of our multiscale approach.
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Affiliation(s)
- Daniel T Lichter
- Cornell Brooks School of Public Policy, Cornell University, Ithaca, NY, USA
| | - Domenico Parisi
- Department of Sociology, Mississippi State University, Mississippi State, MS, USA
| | | | - Christian K Scott
- Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA
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33
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Kureshi N, Abidi SSR, Clarke DB, Zeng W, Feng C. Spatial Hotspots and Sociodemographic Profiles Associated With Traumatic Brain Injury in Nova Scotia. J Neurotrauma 2024; 41:844-861. [PMID: 38047531 DOI: 10.1089/neu.2023.0257] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of death and disability, primarily caused by falls and motor vehicle collisions (MVCs). Although many TBIs are preventable, there is a notable lack of studies exploring the association of geographically defined TBI hotspots with social deprivation. Geographic information systems (GIS) can be used to identify at-risk neighborhoods (hotspots) for targeted interventions. This study aims to determine the spatial distribution of TBI by major causes and to explore the sociodemographic and economic characteristics of TBI hotspots and cold spots in Nova Scotia. Patient data for TBIs from 2003 to 2019 were obtained from the Nova Scotia Trauma Registry. Residential postal codes were geocoded and assigned to dissemination areas (DA). Area-based risk factors and deprivation status (residential instability [RI], economic dependency [ED], ethnocultural composition [EC], and situational vulnerability [SV]) from the national census data were linked to DAs. Spatial autocorrelation was assessed using Moran's I, and hotspot analysis was performed using Getis-Ord Gi* statistic. Differences in risk factors between hot and cold spots were evaluated using the Mann-Whitney U test for numerical variables and the χ2 test or Fisher's exact test for categorical variables. A total of 5394 TBI patients were eligible for inclusion in the study. The distribution of hotspots for falls exhibited no significant difference between urban and rural areas (p = 0.71). Conversely, hotspots related to violence were predominantly urban (p = 0.001), whereas hotspots for MVCs were mostly rural (p < 0.001). Distinct dimensions of deprivation were associated with falls, MVCs, and violent hotspots. Fall hotspots were significantly associated with areas characterized by higher RI (p < 0.001) and greater ethnocultural diversity (p < 0.001). Conversely, the same domains exhibited an inverse relationship with MVC hotspots; areas with low RI and ethnic homogeneity displayed a higher proportion of MVC hotspots. ED and SV exhibited a strong gradient with MVC hotspots; the most deprived quintiles displayed the highest proportion of MVC hotspots compared with cold spots (ED; p = 0.002, SV; p < 0.001). Areas with the highest levels of ethnocultural diversity were found to have a significantly higher proportion of violence-related hotspots than cold spots (p = 0.005). This study offers two significant contributions to spatial epidemiology. First, it demonstrates the distribution of TBI hotspots by major injury causes using the smallest available geographical unit. Second, we disentangle the various pathways through which deprivation impacts the risk of main mechanisms of TBI. These findings provide valuable insights for public health officials to design targeted injury prevention strategies in high-risk areas.
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Affiliation(s)
- Nelofar Kureshi
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - David B Clarke
- Division of Neurosurgery, Dalhousie University, Halifax, Nova Scotia, Canada
- Brain Repair Centre, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Weiping Zeng
- Super GeoAI Technology Inc. Saskatoon, Saskatchewan, Canada
| | - Cindy Feng
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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Skiendzielewski K, Forke CM, Sarwer DB, Noll JG, Wheeler DC, Henry KA, Schroeder K. The intersection of adverse childhood experiences and neighborhood determinants of health: An exploratory spatial analysis. Psychol Trauma 2024; 16:S125-S132. [PMID: 35834220 PMCID: PMC9839886 DOI: 10.1037/tra0001320] [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] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with elevated risk for poor physical and psychological health outcomes. Nearly all of the literature on the association between ACEs and poor health focuses on the individual and family level; the potential role of neighborhood environment is overlooked. Understanding the relationship between ACEs and characteristics of the neighborhood environment is a necessary first step in determining if and how place-based, trauma-informed interventions might mitigate the negative effects of ACEs. The purpose of this exploratory study was to describe the neighborhood environment of adults who have experienced ≥ 4 versus ≤ 3 ACEs. METHOD An exploratory secondary analysis of cross-sectional and geospatial data was conducted during 2021. Data sources included 2011/2012 Philadelphia ACE Survey data, a telephone survey of 1,784 randomly sampled Philadelphia adults, linked with geospatial data on 21 neighborhood-level determinants of health. Neighborhood was defined as participant's home census tract at the time of survey. The sample for this secondary analysis included the 1,679 Philadelphia ACE Survey participants for whom home census tract was available. Bivariate logistic regression examined differences between groups (≤ 3 ACEs vs. ≥ 4 ACEs). RESULTS Individuals with ≥ 4 ACEs lived in neighborhoods with higher neighborhood poverty rates, less socioeconomic resources, worse food access, poorer perceived physical and mental health, more substance overdose deaths, higher crime, and less green space. CONCLUSIONS Findings suggest future work may benefit from considering neighborhood environments when examining and intervening upon the association between ACEs and poor physical and psychological health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | - Christine M. Forke
- Master of Public Health Program, Perelman School of Medicine, University of Pennsylvania
- Center for Violence Prevention, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, United States
| | - David B. Sarwer
- Department of Social and Behavioral Sciences, College of Public Health, Center for Obesity Research and Education, Temple University
| | - Jennie G. Noll
- Department of Human Development and Family Studies, College of Health and Human Development, Pennsylvania State University
| | - David C. Wheeler
- Department of Biostatistics, School of Medicine, Virginia Commonwealth University
| | - Kevin A. Henry
- Department of Geography and Urban Studies, College of Liberal Arts, Temple University
| | - Krista Schroeder
- Department of Nursing, College of Public Health, Temple University
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Min J, Tam V, Mayne S. Pediatric obesity during COVID-19: the role of neighborhood social vulnerability and collective efficacy. Int J Obes (Lond) 2024; 48:550-556. [PMID: 38123839 PMCID: PMC11017973 DOI: 10.1038/s41366-023-01448-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/04/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Childhood obesity increased in the first year of COVID-19 with significant disparities across race, ethnicity, and socioeconomic status. Social distancing led to fewer physical activity opportunities but increased screen time and high-calorie food consumption, all co-determined by neighborhood environments. This study aimed to test the moderation effects of neighborhood socioeconomic and built environments on obesity change during COVID-19. METHODS Using electronic health records from a large pediatric primary care network in 2018-2022, we cross-sectionally examined 163,042 well visits of 2-17-year-olds living in Philadelphia County in order to examine (1) the pandemic's effect on obesity prevalence and (2) moderation by census-tract-level neighborhood socioeconomic disadvantage, crime, food and physical activity-related environments using interrupted-time-series analysis, Poisson regression, and logistic regression. RESULTS Weekly obesity prevalence increased by 4.9 percent points (pp) during the pandemic (January 2021-August 2022) compared to pre-pandemic (March 2018-March 2020) levels. This increase was pronounced across all age groups, racially/ethnically minoritized groups, and insurance types (ranging from 2.0 to 6.4 pp) except the Non-Hispanic-white group. The increase in obesity among children racially/ethnically minoritized groups was significantly larger in the neighborhoods with high social vulnerability (3.3 pp difference between high and low groups), and low collective efficacy (2.0 pp difference between high and low groups) after adjusting for age, sex, and insurance type. CONCLUSIONS Racially/ethnically minoritized children experienced larger obesity increases during the pandemic, especially those in socioeconomically disadvantaged neighborhoods. However, the buffering effect of community collective efficacy on the disparities underscores the importance of environments in pediatric health.
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Affiliation(s)
- Jungwon Min
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Vicky Tam
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Stephanie Mayne
- Clinical Futures and PolicyLab, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics and Leonard Davis Institute of Health Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Santana ADDS, Galdino AS, Araújo ECD. The overcoming of the monogamous family is through the community! Non-monogamous parenting of sex-gender-diverse people. Cien Saude Colet 2024; 29:e19692023. [PMID: 38655970 DOI: 10.1590/1413-81232024294.19692023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/20/2023] [Indexed: 04/26/2024] Open
Abstract
Sex-gender-diverse and non-monogamous strain cisnormativity and mononormativity. In scientific terms, the parenting arrangements of these people are uncertain. Thus, this ethnography aims to understand the perception of non-monogamous sex-gender-diverse people about parenting. The theoretical framework adopted is derived from non-monogamous studies, love and sexuality from the Social and Human Sciences in Public Health and the digital ethnography methodological framework. Fieldwork occurred from 2021 to 2022 through an online WhatsApp group. Participant observation was employed in the group, and semi-structured online interviews were held. Two categories emerged: a) The non-monogamous parenting nodes and b) Collective parenting. In the first, the importance of bonds in affective networks is explored, and the barriers to these family arrangements are exposed. The second describes the importance of living in a community, and Indigenous and Black ancestry is revived. The revived ancestry and ways of living in a community gain importance as we understand their relevance in the experience of parenting for sex-gender-diverse people who are non-monogamous.
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Merom D, Meehan D, Phongsavan P, Gudes O. Quantifying Area-Level Physical Activity Offerings in Social Context: A Novel Concept That Goes Beyond Walkability and Access to Open Spaces. J Phys Act Health 2024; 21:350-356. [PMID: 38335942 DOI: 10.1123/jpah.2023-0418] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/14/2023] [Accepted: 12/13/2023] [Indexed: 02/12/2024]
Abstract
BACKGROUND Social support is a crucial factor influencing the sustainability of physical activity (PA). This proof-of-concept study presents the development of a Social Physical Activity Index for Area (SPAIFA) an indicator reflecting opportunities for individuals to actively participate as part of a group within which opportunities for social interaction can be developed. METHODS Six government councils in the state of New South Wales, Australia, were selected encompassing 174 suburbs. Using 2 search engines' map tools, we identified PA venues for each suburb (eg, park, studios, etc). To enumerate activities per suburb, we used (1) venue websites, (2) New South Wales Office of Sport website, (3) national websites of grassroots PA for nonorganized activity (eg, parkrun, meetup, etc), and (4) social media. The database was linked to the suburb demographic profile, the area disadvantage score, walkability and open space scores, and the proportion of insufficiently active residents. Spatial analysis techniques were used to identify SPAIFA clusters. RESULTS SPAIFA councils' average was 9.9 activities per 10,000 people (ranging from 6.6/10,000 to 16.2/10,000). SPAIFA-Old (ie, activities specific to older adults) varied significantly (ranging from 11.7/10,000 to 0.8/10,000 seniors). Disadvantaged areas and a high proportion of insufficiently active residents were associated with being classified as low SPAIFA (P < .01). Three clusters of low SPAIFA were identified, and 17 high-risk areas where low SPAIFA was compounded by poor environmental support. CONCLUSIONS SPAIFA can be used by councils and policymakers as an indicator for monitoring and intervening in areas where natural and/or urban design is not conducive for PA.
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Affiliation(s)
- Dafna Merom
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Drew Meehan
- School of Health Sciences, Western Sydney University, Penrith, NSW, Australia
| | - Philayrath Phongsavan
- Faculty of Medicine and Health, Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
| | - Ori Gudes
- Faculty of Medicine, School of Population Health, University of New South Wales, Sydney, NSW, Australia
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Ganbavale S, Papachristou E, Mathers J, Papacosta A, Lennon L, Whincup P, Wannamethee S, Ramsay S. Neighborhood Deprivation and Changes in Oral Health in Older Age: A Longitudinal Population-Based Study. J Dent Res 2024; 103:434-441. [PMID: 38414259 PMCID: PMC10966931 DOI: 10.1177/00220345231224337] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
The aim of this study was to examine the extent to which neighborhood-level socioeconomic factors (objective and perceived) are associated with poor oral health in older adults over time, independent of individual socioeconomic position. Data for this cross-sectional and longitudinal observation study came from a socially and geographically representative cohort of men aged 71 to 92 y in 2010-12 (n = 1,622), drawn from British general practices, which was followed up in 2018-19 (aged 78-98 y; N = 667). Dental measures at both times included number of teeth, periodontal pocket depth, self-rated oral health, and dry mouth. Neighborhood deprivation was based on Index of Multiple Deprivation (IMD) and a cumulative index measuring perceptions about local environment. Individual-level socioeconomic position was based on longest-held occupation. Multilevel and multivariate logistic regressions, adjusted for relevant sociodemographic, behavioral, and health-related factors, were performed to examine the relationships of dental measures with IMD and perceived neighborhood quality index, respectively. Cross-sectionally, risks of tooth loss, periodontal pockets, and dry mouth increased from IMD quintiles 1 to 5 (least to most deprived); odds ratios (ORs) for quintile 5 were 2.22 (95% confidence interval [CI], 1.41-3.51), 2.82 (95% CI, 1.72-4.64), and 1.51 (95% CI, 1.08-2.09), respectively, after adjusting for sociodemographic, behavioral, and health-related factors. Risks of increased pocket depth and dry mouth were significantly greater in quintile 5 (highest problems) of perceived neighborhood quality index compared to quintile 1. Over the 8-y follow-up, deterioration of dentition (tooth loss) was significantly higher in the most deprived IMD quintiles after full adjustment (OR for quintile 5 = 2.32; 95% CI, 1.09-4.89). Deterioration of dentition and dry mouth were significantly greater in quintile 5 of perceived neighborhood quality index. Neighborhood-level factors were associated with poor oral health in older age, both cross-sectionally and longitudinally, particularly with tooth loss, and dry mouth, independent of individual-level socioeconomic position.
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Affiliation(s)
- S.G. Ganbavale
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, North East England, UK
| | - E. Papachristou
- Department of Primary Care and Population Health, UCL, London, UK
| | - J.C. Mathers
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, North East England, UK
| | - A.O. Papacosta
- Department of Primary Care and Population Health, UCL, London, UK
| | - L.T. Lennon
- Department of Primary Care and Population Health, UCL, London, UK
| | - P.H. Whincup
- Population Health Research Institute, St George’s, University of London, London, UK
| | - S.G. Wannamethee
- Department of Primary Care and Population Health, UCL, London, UK
| | - S.E. Ramsay
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, North East England, UK
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Shakya S, Silva SG, McConnell ES, McLaughlin SJ, Cary MP. Psychosocial stressors associated with frailty in community-dwelling older adults in the United States. J Am Geriatr Soc 2024; 72:1088-1099. [PMID: 38391046 DOI: 10.1111/jgs.18821] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/14/2024] [Accepted: 01/21/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Frailty is multifactorial; however, psychosocial stressors contributing to frailty are poorly understood. This study aimed to examine whether gender, race/ ethnicity, and education are associated with differential exposure to psychosocial stressors, determine psychosocial stressors contributing to frailty, and explore the mediating psychosocial stressors pathway. METHODS This cross-sectional study involved 7679 community-dwelling older adults (≥65) from the Health and Retirement Study (2006 and 2008 waves). Psychosocial stressors such as loneliness, low subjective social status, financial strain, poor neighborhood cohesion, everyday discrimination, and traumatic life events were measured. Frailty was defined by the Fried phenotype measure. Multivariable logistic regressions were used to examine the association of gender, race/ethnicity, and education with psychosocial stressors, psychosocial stressors associated with frailty, and the mediating psychosocial stressors pathway. RESULTS Females experienced greater financial strain but lower discrimination (both p < 0.05). Older adults who identified as Hispanic, Black, and racially or ethnically minoritized experienced low subjective social status, high financial strain, low neighborhood cohesion, and high discrimination than their White counterparts (all p < 0.05). Those with lower education experienced high loneliness, low subjective social status, high financial strain, low neighborhood cohesion but lower traumatic life events (all p < 0.05). Psychosocial stressors: High loneliness, low subjective social status, high financial strain, and low neighborhood cohesion (all p < 0.05) independently increased the odds of frailty. The mediating pathway of psychosocial stressors was not significant. CONCLUSION: Disparities exist in exposure to psychosocial stressors associated with frailty. Multilevel interventions are needed to reduce the influence of psychosocial stressors on frailty.
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Affiliation(s)
- Shamatree Shakya
- College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Susan G Silva
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Eleanor S McConnell
- Department of Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center (GRECC), Durham, North Carolina, USA
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Michael P Cary
- School of Nursing, Duke University, Durham, North Carolina, USA
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Goldman AW, Bea MD. Banking on the Neighborhood? Inequalities in Older Adults' Access to Local Banking and Neighborhood Perceptions. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad194. [PMID: 38155541 PMCID: PMC10923209 DOI: 10.1093/geronb/gbad194] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Indexed: 12/30/2023] Open
Abstract
OBJECTIVES Access to local banking represents an understudied dimension of neighborhood-based inequalities that could significantly influence older adults' perceptions of their neighborhood spaces in ways that matter for disparities in well-being. We evaluate disparities in banking access and then examine how local banking access informs older adults' perceptions of neighborhood collective efficacy and danger, above and beyond other neighborhood socioeconomic characteristics. METHODS We use nationally representative data from older adults in the United States who were interviewed at Round 3 of the National Social Life, Health, and Aging Project, linked with data on banks in respondents' residential and surrounding census tracts from the National Establishment Time-Series database, in a series of bivariate and multivariable regression analyses. RESULTS White older adults and those with higher levels of education have significantly greater local banking access than Black and Hispanic older adults and those with lower levels of education. Higher rates of local banking institutions are associated with significantly lower perceptions of neighborhood danger, but not with perceived collective efficacy. This finding emerges when accounting for neighborhood concentrated disadvantage and physical disorder. DISCUSSION Local banks may represent neighborhood investment and the broader economic vitality of a community, as well as the ability of communities to meet older adults' everyday needs in ways that enhance older residents' feelings of safety. Increasing access to local financial institutions may help attenuate neighborhood-based contributors to inequalities in health and well-being among the older adult population.
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Affiliation(s)
- Alyssa W Goldman
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
| | - Megan Doherty Bea
- Department of Consumer Science, University of Wisconsin—Madison, Madison, Wisconsin, USA
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Ren Y, Zuo C, Ming H, Zhang Y, Huang S. Long-term Neighborhood Poverty Effects on Internalizing Symptoms in Adolescents: Mediated Through Allostatic Load and Pubertal Timing. J Adolesc Health 2024; 74:689-695. [PMID: 37804296 DOI: 10.1016/j.jadohealth.2023.08.027] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/28/2023] [Accepted: 08/16/2023] [Indexed: 10/09/2023]
Abstract
PURPOSE The long-term effect of neighborhood poverty on internalizing symptoms in adolescents and the biological mechanisms underlying this association remain unclear. We defined neighborhood poverty at the village level in two dimensions: intensity (i.e., poverty rate) and duration. This study investigated how the poverty rate and duration of exposure to neighborhood poverty interact to predict internalizing symptoms in adolescents through biological mechanisms (i.e., allostatic load and early pubertal timing). METHODS A total of 418 adolescents (50.2% girls; 11-14 years old; mean age = 12.57 years) living in rural China participated in two waves of data collection. Path analysis was conducted to examine the mediating role of allostatic load and pubertal timing in the relationship between the duration of exposure to neighborhood poverty and internalizing symptoms. Moreover, the interactive effect between the poverty rate and duration of neighborhood poverty on the allostatic load was tested. RESULTS The positive association between the duration of exposure to neighborhood poverty and internalizing symptoms of adolescents was explained by elevated allostatic load and early pubertal timing after adjusting for gender, age, prior family socioeconomic states and internalizing symptoms. The duration in neighborhood poverty was a stronger predictor of allostatic load for adolescents living in high poverty rate neighborhoods than for those living in low poverty rate neighborhoods. DISCUSSION Neighborhood poverty gets "under the skin" through biological pathways and affects internalizing symptoms among adolescents. The findings highlight the importance of considering different dimensions of neighborhood poverty (e.g., intensity and duration) on adolescents' health.
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Affiliation(s)
- Yi Ren
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, China
| | - Chenyi Zuo
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, China
| | - Hua Ming
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, China
| | - Ye Zhang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, China
| | - Silin Huang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, China.
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Suarez GL, Burt SA, Gard AM, Klump KL, Hyde LW. Exposure to community violence as a mechanism linking neighborhood disadvantage to amygdala reactivity and the protective role of parental nurturance. Dev Psychol 2024; 60:595-609. [PMID: 38386381 DOI: 10.1037/dev0001712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024]
Abstract
Emerging literature links neighborhood disadvantage to altered neural function in regions supporting socioemotional and threat processing. Few studies, however, have examined the proximal mechanisms through which neighborhood disadvantage is associated with neural functioning. In a sample of 7- to 19-year-old twins recruited from disadvantaged neighborhoods (354 families, 708 twins; 54.5% boys; 78.5% White, 13.0% Black, 8.5% other racial/ethnic group membership), we found that exposure to community violence was related to increased amygdala reactivity during socioemotional processing and may be one mechanism linking neighborhood disadvantage to amygdala functioning. Importantly, parenting behavior appeared to modulate these effects, such that high parental nurturance buffered the effect of exposure to community violence on amygdala reactivity. These findings elucidate the potential impact of exposure to community violence on brain function and highlight the role parents can play in protecting youth from the neural effects of exposure to adversity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | - Luke W Hyde
- Department of Psychology, University of Michigan
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Schmidt S, Jacobs MA, Kim J, Hall DE, Stitzenberg KB, Kao LS, Brimhall BB, Wang CP, Manuel LS, Su HD, Silverstein JC, Shireman PK. Presentation Acuity and Surgical Outcomes for Patients With Health Insurance Living in Highly Deprived Neighborhoods. JAMA Surg 2024; 159:411-419. [PMID: 38324306 PMCID: PMC10851138 DOI: 10.1001/jamasurg.2023.7468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Accepted: 10/14/2023] [Indexed: 02/08/2024]
Abstract
Importance Insurance coverage expansion has been proposed as a solution to improving health disparities, but insurance expansion alone may be insufficient to alleviate care access barriers. Objective To assess the association of Area Deprivation Index (ADI) with postsurgical textbook outcomes (TO) and presentation acuity for individuals with private insurance or Medicare. Design, Setting, and Participants This cohort study used data from the National Surgical Quality Improvement Program (2013-2019) merged with electronic health record data from 3 academic health care systems. Data were analyzed from June 2022 to August 2023. Exposure Living in a neighborhood with an ADI greater than 85. Main Outcomes and Measures TO, defined as absence of unplanned reoperations, Clavien-Dindo grade 4 complications, mortality, emergency department visits/observation stays, and readmissions, and presentation acuity, defined as having preoperative acute serious conditions (PASC) and urgent or emergent cases. Results Among a cohort of 29 924 patients, the mean (SD) age was 60.6 (15.6) years; 16 424 (54.9%) were female, and 13 500 (45.1) were male. A total of 14 306 patients had private insurance and 15 618 had Medicare. Patients in highly deprived neighborhoods (5536 patients [18.5%]), with an ADI greater than 85, had lower/worse odds of TO in both the private insurance group (adjusted odds ratio [aOR], 0.87; 95% CI, 0.76-0.99; P = .04) and Medicare group (aOR, 0.90; 95% CI, 0.82-1.00; P = .04) and higher odds of PASC and urgent or emergent cases. The association of ADIs greater than 85 with TO lost significance after adjusting for PASC and urgent/emergent cases. Differences in the probability of TO between the lowest-risk (ADI ≤85, no PASC, and elective surgery) and highest-risk (ADI >85, PASC, and urgent/emergent surgery) scenarios stratified by frailty were highest for very frail patients (Risk Analysis Index ≥40) with differences of 40.2% and 43.1% for those with private insurance and Medicare, respectively. Conclusions and Relevance This study found that patients living in highly deprived neighborhoods had lower/worse odds of TO and higher presentation acuity despite having private insurance or Medicare. These findings suggest that insurance coverage expansion alone is insufficient to overcome health care disparities, possibly due to persistent barriers to preventive care and other complex causes of health inequities.
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Affiliation(s)
- Susanne Schmidt
- Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio
| | - Michael A. Jacobs
- Department of Surgery, University of Texas Health San Antonio, San Antonio
| | - Jeongsoo Kim
- Department of Surgery, University of Texas Health San Antonio, San Antonio
| | - Daniel E. Hall
- Center for Health Equity Research and Promotion, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Geriatric Research Education and Clinical Center, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | - Lillian S. Kao
- Department of Surgery, McGovern Medical School, The University of Texas Health Science Center at Houston
| | - Bradley B. Brimhall
- Department of Pathology and Laboratory Medicine, University of Texas Health San Antonio, San Antonio
- University Health, San Antonio, Texas
| | - Chen-Pin Wang
- Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio
| | - Laura S. Manuel
- Department of Population Health Sciences, University of Texas Health San Antonio, San Antonio
- UT Health Physicians Business Intelligence and Data Analytics, University of Texas Health San Antonio, San Antonio
| | - Hoah-Der Su
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jonathan C. Silverstein
- Department of Biomedical Informatics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Paula K. Shireman
- Department of Surgery, University of Texas Health San Antonio, San Antonio
- University Health, San Antonio, Texas
- Department of Primary Care and Rural Medicine, School of Medicine, Texas A&M University, Bryan
- Department of Medical Physiology, School of Medicine, Texas A&M University, Bryan
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Shewark EA, Vazquez AY, Pearson AL, Klump KL, Burt SA. Neighborhood features moderate genetic and environmental influences on children's social information processing. Dev Psychol 2024; 60:610-623. [PMID: 38421787 DOI: 10.1037/dev0001690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Neighborhood is a key context where children learn to process social information; however, the field has largely overlooked the ways children's individual characteristics might be moderated by neighborhood effects. We examined 1,030 six- to 11-year-olds (48.7% female; 82% White) twin pairs oversampled for neighborhood disadvantage from the Twin Study of Behavioral and Emotional Development in Children. We evaluated neighbor reports (N = 1,880) of neighborhood structural and social characteristics as moderators of genetic and environmental influences on children's social processing. Although there was no evidence of moderation for children's hostile attributions, there was robust evidence that the social and structural characteristics of the neighborhood moderated the genetic and environmental origins of children's positive expectations of aggressive behavior. Specifically, we found that genetic influences on aggressive expectations increased in the presence of neighborhood deprivation and decreased in the presence of protective social processes and availability of resources. Such findings suggest that protective neighborhood social processes may buffer against the development of aggressive expectations during middle childhood by suppressing the expression of genetic influences on those outcomes. In doing so, they suggest that neighborhood social processes may be able to promote youth resilience to neighborhood deprivation "under the skin." (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Amber L Pearson
- Charles Stewart Mott Department of Public Health, Michigan State University
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Bhor N, Mayavel D. A study on analysing sociospatial distribution and equity in access to urban parks in Bengaluru, India. Lancet Planet Health 2024; 8 Suppl 1:S13. [PMID: 38632908 DOI: 10.1016/s2542-5196(24)00078-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
BACKGROUND Given the effect of urbanisation on land use, allocation, and implementation of urban green spaces, we attempt to analyse the sociospatial distribution and equity in access to urban parks in Bengaluru, India, also known as the garden city of India. METHODS Geospatial method was used for mapping the park's distribution and measuring the accessibility using road network data. To understand equitable access to the parks, four socioeconomic parameters from 2011 census (ie, population density, children aged 6 years or younger, proxy wealth index, and the Scheduled Caste population) were correlated with the parks' accessibility. FINDINGS The spatial distribution revealed that 19 of 198 wards did not have a single park and 36 wards only had one park. About 25-29% of wards did not have accessibility to neighbourhood-level and community-level parks within a 400-800 m distance. These parks must be accessible within walking distance of 400-800 m but were found to most likely be inaccessible in the periphery where population density was low and children population was high in comparison to the central part of the city. Similarly, parks found inaccessible in the eastern part of the city where the scheduled caste population is high, and also found inaccessible to the low-income neighbourhoods residing in the western part and southern periphery of the city, indicating the uneven distribution and inequitable access to public parks. INTERPRETATION Our study proposes reshaping of both neighbourhood parks and community parks, an attempt to look beyond biodiversity. The affirmative actions in terms of availability of public parks with adequate area requirement and essential services at a neighbourhood scale is required to redress the inequity of access. In addition, accessibility to parks must be considered important in urban planning. FUNDING None.
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Affiliation(s)
- Nilanjan Bhor
- Indian Institute for Human Settlements, Bangalore, India.
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Choi EY, Cho G, Chang VW. Neighborhood Social Environment and Dementia: The Mediating Role of Social Isolation. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbad199. [PMID: 38180790 DOI: 10.1093/geronb/gbad199] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Indexed: 01/06/2024] Open
Abstract
OBJECTIVES Despite the potential importance of the neighborhood social environment for cognitive health, the connection between neighborhood characteristics and dementia remains unclear. This study investigated the association between the prospective risk of dementia and three distinct aspects of neighborhood social environment: socioeconomic deprivation, disorder, and social cohesion. We also examined whether objective and subjective aspects of individual-level social isolation may function as mediators. METHODS Leveraging data from the Health and Retirement Study (2006-2018; N = 9,251), we used Cox proportional hazards models to examine the association between time-to-dementia incidence and each neighborhood characteristic, adjusting for covariates and the propensity to self-select into disadvantaged neighborhoods. We used inverse odds weighting to decompose significant total effects of neighborhood characteristics into mediational effects of objective and subjective social isolation. RESULTS The risk of dementia was associated with deprivation and disorder but not low cohesion. In deprived neighborhoods, individuals had an 18% increased risk of developing dementia (cause-specific hazard ratio [CHR] = 1.18, 95% CI: 1.02 to 1.38), and those in disordered areas had a 27% higher risk (CHR = 1.27, 95% CI: 1.03 to 1.59). 20% of the disorder's effects were mediated by subjective social isolation, while the mediational effects of objective isolation were nonsignificant. Deprivation's total effects were not partitioned into mediational effects given its nonsignificant associations with the mediators. DISCUSSION Neighborhood deprivation and disorder may increase middle to older adults' risks of dementia. The disorder may adversely affect cognitive health through increasing loneliness. Our results suggest a clear need for dementia prevention targeting upstream neighborhood contexts, including the improvement of neighborhood conditions to foster social integration among residents.
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Affiliation(s)
- Eun Young Choi
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Gawon Cho
- Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Virginia W Chang
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, New York, USA
- Department of Population Health, Grossman School of Medicine, New York University, New York, New York, USA
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Bjørndal LD, Ebrahimi OV, Lan X, Nes RB, Røysamb E. Mental health and environmental factors in adults: A population-based network analysis. Am Psychol 2024; 79:368-383. [PMID: 37439756 DOI: 10.1037/amp0001208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023]
Abstract
Few studies have assessed the multifactorial nature of environmental influences on population mental health. In this large-scale, population-based study of adults, we applied network analysis to study the relationship between environmental factors and symptoms of depression, anxiety, and well-being. We estimated networks with overall mental health nodes and individual symptoms to assess both broad and fine-grained associations between environmental factors and mental health. Finally, we conducted an out-of-sample replication in an independent large-scale sample to assess the robustness of our results. Across 31,000 adults randomly sampled from the Norwegian population, we identified associations between numerous environmental characteristics and mental health. Recent discrimination and unsupportive social environments were strongly associated with lower population well-being and higher levels of mental illness symptoms, respectively. The most strongly connected variables in the networks were environmental factors, including perceived problems with crime, violence, or vandalism in the residential area, worrying about violence or threats when outside, and problems with noise or contamination at home. Substantial variation in population mental health was explained by environmental factors included in the networks. Replicability of the results was excellent and suggestive of strong robustness of the results across samples. Our findings are indicative of the importance of environmental factors, such as the social environment, housing satisfaction, and residential area characteristics, for multiple aspects of population mental health. We identify several environmental factors that represent potentially useful targets for future studies and public health efforts seeking to improve mental health in the general population. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Xiaoyu Lan
- Department of Psychology, PROMENTA Research Center, University of Oslo
| | - Ragnhild Bang Nes
- Department of Psychology, PROMENTA Research Center, University of Oslo
| | - Espen Røysamb
- Department of Psychology, PROMENTA Research Center, University of Oslo
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Hong JS, Choi J, Burlaka V, Burlaka J, Marsack-Topolewski CN, Voisin DR. Bullying Victimization and Suicidal Thoughts: Emotional Distress and Neighborhood Conditions. Arch Suicide Res 2024; 28:499-511. [PMID: 37013796 DOI: 10.1080/13811118.2023.2192755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
The study aims to examine (1) the association between bullying victimization and suicidal thoughts and (2) neighborhood conditions as a moderated mediated model of the association between bullying victimization, emotional distress, and suicidal thoughts. The sample consists of 414 African American youths (ages 12-17) in Chicago's Southside neighborhoods. Variables included suicidal thoughts, bullying victimization, emotional distress, neighborhood conditions, age, sex, and government assistance. Analyses included descriptive statistics, bivariate correlations, and multivariate regression analyses. The study found that bullying victimization was not directly associated with suicidal thoughts. However, bullying victimization was positively associated with emotional distress, which was related to suicidal thoughts. Moreover, emotional distress as a mediator of the association between bullying victimization and suicidal thoughts was observed when neighborhood conditions were a moderator. The findings suggest that bullying victimization and suicidal thoughts are major concerns for African American adolescents, and prevention and intervention need to be cost-effective.
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Dubowitz T, Ghosh-Dastidar B, Beckman R, Richardson AS, Hunter GP, Burns RM, Cantor J, Mendoza-Graf A, Collins RL. Community Investments and Diet-Related Outcomes: A Longitudinal Study of Residents of Two Urban Neighborhoods. Am J Prev Med 2024; 66:681-689. [PMID: 37972799 PMCID: PMC10957323 DOI: 10.1016/j.amepre.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 11/07/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
INTRODUCTION Investments in historically oppressed neighborhoods through food retail, housing, and commercial development are hypothesized to improve residents' health, nutrition, and perceptions of their neighborhood as a place to live. Although place-based development (e.g., housing, retail, business assistance) is happening in many communities, there is little evidence of the long-term correlates of multiple investments such as health and nutrition among residents. METHODS A quasi-experimental longitudinal study was conducted using a cohort of randomly sampled households in two low-income, predominantly African American neighborhoods in Pittsburgh, PA, with surveys assessing residents' food insecurity, perception of their neighborhood as a place to live, perception of access to healthy foods, and dietary outcomes in 2011 and seven years later (2018), with an interim assessment in 2014. Analyses conducted in 2022 compared changes among residents of one neighborhood which had 2.6 times the investments over a 7-year period with changes among residents of a socio-demographically similar neighborhood that received fewer investments. RESULTS It was found that residents in the neighborhood receiving substantial investments demonstrated statistically significant improvements in neighborhood satisfaction (12.6% improvement compared with a 2.2% decrease) and perceived access to healthy food (52% improvement compared with 18.2% improvement), and marginally significant change in food security (14% compared with 4.8% improvement) compared with residents in the neighborhood receiving fewer investments. CONCLUSIONS Multiple place-based investments in neighborhoods can potentially induce positive change for residents in health and nutrition outcomes.
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Affiliation(s)
- Tamara Dubowitz
- RAND Behavioral & Policy Sciences, Pittsburgh, Pennsylvania.
| | | | - Robin Beckman
- RAND Research Programming Group, Santa Monica, California
| | | | | | - Rachel M Burns
- RAND Economics, Sociology & Statistics, Pittsburgh, Pennsylvania
| | - Jonathan Cantor
- RAND Economics, Sociology & Statistics, Santa Monica, California
| | | | - Rebecca L Collins
- RAND Behavioral & Policy Sciences, Santa Monica, California; Department of Behavioral and Policy Sciences, RAND Corporation, Pittsburgh, Pennsylvania
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Jing F, Liu L, Zhou S, Feng J. How Does Crime-Specific Victimization Impact Fear of Crime in Urban China? The Role of Neighborhood Characteristics. Int J Offender Ther Comp Criminol 2024; 68:540-565. [PMID: 34933591 DOI: 10.1177/0306624x211066829] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Past research has failed to find consistent relationships between criminal victimization and fear of crime. Except for neighborhood disorder and crime rate, few studies have examined whether other neighborhood conditions matter the victimization-fear relationship. Using survey data in Guangzhou neighborhoods, the present analysis employs multinomial logistic regression models to examine whether neighborhood characteristics moderate the relationship between violent victimization and fear of violence, and between burglary victimization and fear of burglary, separately. Some aspects of the neighborhood environment do differentially influence victims' and non-victims' fear levels. Besides verifying the interaction effect of neighborhood disorder and victimization, the present study finds that neighborhood policing alleviates the harmful effect of violent victimization on fear, while collective efficacy fosters the harmful effect of burglary victimization on fear. This paper underscores the significance of the social context of urban China in explaining the interplay of neighborhood characteristics and victimization on fear of crime.
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Affiliation(s)
| | - Lin Liu
- University of Cincinnati, OH, USA
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