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Muchomba FM, Teitler JO, Fox C, Reichman NE. Racialized Police Use of Force and Maternal Health. Am J Prev Med 2024:S0749-3797(24)00412-4. [PMID: 39617107 DOI: 10.1016/j.amepre.2024.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 11/25/2024] [Accepted: 11/26/2024] [Indexed: 01/12/2025]
Abstract
INTRODUCTION There are large racial disparities in maternal health that cannot be explained by education, income, or other individual-level risk factors. This cross-sectional study estimated associations between racial inequity in police use of force at the community level and health outcomes of Black and White women. METHODS Birth records were linked to maternal hospital discharge records and municipal police department data for 326,240 births occurring between January 1, 2012, and December 31, 2016, to Black and White women in the state of New Jersey. Outcomes, identified using diagnosis and procedure codes, were substance use (any/tobacco/alcohol/other), mental health disorders (any/depression/anxiety/other), asthma, obesity, hypertension (pre-existing/gestational), diabetes (pre-existing/gestational), severe maternal morbidity, other cardiovascular diseases, and preterm labor. Data were analyzed in 2024. RESULTS For Black women, living in a community with 1% greater racially-disproportionate police use of force was associated with higher odds of any mental health disorder (by 0.18%; 95% CI=0.08, 0.28), depression (0.19%; 95% CI=0.05, 0.33), anxiety (0.25%; 95% CI=0.09, 0.41), other mental health disorder (0.17%; 95% CI=0.07, 0.27), any substance use (0.26%; 95% CI=0.14, 0.38), tobacco use (0.31%; 95% CI=0.16, 0.46), other substance use (0.17%; 95% CI=0.04, 0.30), asthma (0.12%; 95% CI=0.04, 0.21), and preterm labor (0.17%; 95% CI=0.05, 0.29) in adjusted models. There were no robust associations with the other outcomes for Black women or with any of the outcomes for White women. CONCLUSIONS Racially-disproportionate police use of force was significantly associated with mental illness, substance use, asthma, and preterm labor of Black women. Results underscore the potential importance of institutionalized racism as a fundamental cause of health disparities.
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Burford KG, Itzkowitz NG, Ortega AG, Teitler JO, Rundle AG. Use of Generative AI to Identify Helmet Status Among Patients With Micromobility-Related Injuries From Unstructured Clinical Notes. JAMA Netw Open 2024; 7:e2425981. [PMID: 39136946 PMCID: PMC11322845 DOI: 10.1001/jamanetworkopen.2024.25981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 05/15/2024] [Indexed: 08/16/2024] Open
Abstract
Importance Large language models (LLMs) have potential to increase the efficiency of information extraction from unstructured clinical notes in electronic medical records. Objective To assess the utility and reliability of an LLM, ChatGPT-4 (OpenAI), to analyze clinical narratives and identify helmet use status of patients injured in micromobility-related accidents. Design, Setting, and Participants This cross-sectional study used publicly available, deidentified 2019 to 2022 data from the US Consumer Product Safety Commission's National Electronic Injury Surveillance System, a nationally representative stratified probability sample of 96 hospitals in the US. Unweighted estimates of e-bike, bicycle, hoverboard, and powered scooter-related injuries that resulted in an emergency department visit were used. Statistical analysis was performed from November 2023 to April 2024. Main Outcomes and Measures Patient helmet status (wearing vs not wearing vs unknown) was extracted from clinical narratives using (1) a text string search using researcher-generated text strings and (2) the LLM by prompting the system with low-, intermediate-, and high-detail prompts. The level of agreement between the 2 approaches across all 3 prompts was analyzed using Cohen κ test statistics. Fleiss κ was calculated to measure the test-retest reliability of the high-detail prompt across 5 new chat sessions and days. Performance statistics were calculated by comparing results from the high-detail prompt to classifications of helmet status generated by researchers reading the clinical notes (ie, a criterion standard review). Results Among 54 569 clinical notes, moderate (Cohen κ = 0.74 [95% CI, 0.73-0.75) and weak (Cohen κ = 0.53 [95% CI, 0.52-0.54]) agreement were found between the text string-search approach and the LLM for the low- and intermediate-detail prompts, respectively. The high-detail prompt had almost perfect agreement (κ = 1.00 [95% CI, 1.00-1.00]) but required the greatest amount of time to complete. The LLM did not perfectly replicate its analyses across new sessions and days (Fleiss κ = 0.91 across 5 trials; P < .001). The LLM often hallucinated and was consistent in replicating its hallucinations. It also showed high validity compared with the criterion standard (n = 400; κ = 0.98 [95% CI, 0.96-1.00]). Conclusions and Relevance This study's findings suggest that although there are efficiency gains for using the LLM to extract information from clinical notes, the inadequate reliability compared with a text string-search approach, hallucinations, and inconsistent performance significantly hinder the potential of the currently available LLM.
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Muchomba FM, Teitler JO, Reichman NE. Municipal social expenditures and maternal health disparities: a study of linked birth and hospitalisation records. J Epidemiol Community Health 2023; 78:jech-2023-220558. [PMID: 37875339 PMCID: PMC11039565 DOI: 10.1136/jech-2023-220558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
BACKGROUND Local government expenditures provide services and benefits that can affect health but the extent to which they are associated with narrowing or widening of racial/ethnic and socioeconomic disparities in health is unknown. We examined race/ethnicity-stratified and education-stratified associations between municipal social expenditures-those on housing, transportation, education, and other society-wide needs-and serious life-threatening maternal health conditions in a large US state. METHODS In this cross-sectional study, we used individual birth records for 1 003 974 births in the state of New Jersey from 1 January 2008 to 31 December 2018 linked to individual maternal hospital discharge records and municipality-level characteristics for 564 municipalities. Severe maternal morbidity (SMM) was identified in the discharge records using a measure developed by the US Centers for Disease Control and Prevention. Associations between municipal-level social expenditures per capita and SMM were estimated using multilevel logistic models. RESULTS Residing in a municipality with higher social expenditures was associated with lower odds of SMM across all racial/ethnic groups and education levels. Overall, 1% higher annual social expenditures per capita was associated with 0.21% (95% CI -0.29 to -0.13) lower odds of SMM. The associations were greater for individuals with less than a high school education than for those in the other educational groups in both relative (lnOR -0.53; 95% CI -0.74 to -0.31) and absolute (β -0.013; 95% CI -0.019 to -0.008) terms. CONCLUSION Municipal-level spending on social services is associated with narrowing socioeconomic disparities in SMM. Narrowing racial/ethnic disparities in maternal health will likely require intervening beyond the provision of services to addressing historical and ongoing structural factors.
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Teitler JO, Chegwin V, Li L, Liu K, Bearman PS, Gorney-Daley MA, Reichman NE. Trends in Elective Deliveries in California and New Jersey. AJPM FOCUS 2023; 2:100052. [PMID: 37789944 PMCID: PMC10546565 DOI: 10.1016/j.focus.2022.100052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
Introduction Cesarean section deliveries in the U.S. increased from 5% of births in 1970 to 32% in 2020. Little is known about trends in cesarean sections and inductions in low-risk pregnancies (i.e., those for which interventions would not be medically necessary). This study addresses the following questions: (1) what is the prevalence of elective deliveries at the population level?, (2) how has that changed over time?, and (3) to what extent do the rates of elective deliveries vary across the population? Methods We first documented long-term trends in cesarean sections in the U.S., California, and New Jersey. We then used linked birth and hospital discharge records and an algorithm based on Joint Commission guidelines to identify low-risk pregnancies and document trends in cesarean sections and inductions in low-risk pregnancies in California and New Jersey over a recent 2-decade period, overall and by maternal characteristics and gestational age. Results In low-risk pregnancies in California and New Jersey, rates of cesarean sections and inductions increased sharply from the early 1990s through the mid-2000s, peaked at 33% in California and 41% in New Jersey in 2007, and then declined somewhat, and the proportions of inductions that were followed by cesarean sections increased from fewer than 1 in 5 to about 1 in 4. More education, non-Hispanic White race/ethnicity, U.S.-born status, and non-Medicaid were associated with higher rates of interventions. Trends were similar across all socioeconomic groups, but differences have been narrowing in California. Among early-term (gestational age of 37-38 weeks) births in low-risk pregnancies, the rates of elective deliveries increased substantially in both states until the mid/late-2000s, peaked at about 35% in California and over 40% in New Jersey, and then decreased in both states to about 20%. Conclusions Given established health risks of nonmedically necessary cesarean sections, that a nontrivial share of induced deliveries in low-risk pregnancies result in cesarean sections, and that interventions in low-risk pregnancies have not substantially declined since their peak in the mid-2000s, the trends documented in this paper suggest that sustained, even increased, public health attention is needed to address the still-too-high rates of cesarean sections and inductions in the U.S.
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Reed MN, Li L, Pesando LM, Harris LE, Furstenberg FF, Teitler JO. Communication with Kin in the Wake of the COVID-19 Pandemic. SOCIUS : SOCIOLOGICAL RESEARCH FOR A DYNAMIC WORLD 2023; 9:10.1177/23780231231199388. [PMID: 38435742 PMCID: PMC10906743 DOI: 10.1177/23780231231199388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
This study investigates patterns of communication among non-coresident kin in the aftermath of the COVID-19 pandemic using data from the New York City Robin Hood Poverty Tracker. Over half of New Yorkers spoke to their non-coresident family members several times a week during the pandemic and nearly half increased their communication with non-coresident kin since March 2020. Siblings and extended kin proved to be especially important ties activated during the pandemic. New Yorkers were most likely to report increased communication with siblings. A quarter of respondents reported that they increased communication with at least one aunt, uncle, cousin, or other extended family member. While non-Hispanic White respondents reported the highest frequency of communication with kin, it was those groups most impacted by COVID-19 - foreign-born, Black, and Hispanic New Yorkers - who were most likely to report that they increased communication with kin in the wake of the pandemic.
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Liu KY, Teitler JO, Rajananda S, Chegwin V, Bearman PS, Hegyi T, Reichman NE. Elective Deliveries and the Risk of Autism. Am J Prev Med 2022; 63:68-76. [PMID: 35367106 PMCID: PMC9232972 DOI: 10.1016/j.amepre.2022.01.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 01/04/2022] [Accepted: 01/19/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Cesarean section and induced deliveries have increased substantially in the U.S., coinciding with increases in autism spectrum disorder. Studies have documented associations between cesarean section deliveries and autism spectrum disorder but have not comprehensively accounted for medical risks. This study evaluates the extent to which cesarean section and induced deliveries are associated with autism spectrum disorder in low-risk births. METHODS In this retrospective cohort study, California's birth records (1992-2012) were linked to hospital discharge records to identify low-risk births using a stringent algorithm based on Joint Commission guidelines. Autism spectrum disorder status was based on California Department of Developmental Service data. Logistic regression models were used to estimate associations between autism spectrum disorder and induced vaginal deliveries, cesarean section deliveries not following induction, and cesarean section deliveries following induction, with noninduced vaginal deliveries as the reference category. RESULTS A total of 1,488,425 low-risk births took place in California from 1992 to 2012. The adjusted odds of autism spectrum disorder were 7% higher for induced vaginal deliveries (AOR=1.07, 95% CI=1.01, 1.14), 26% higher for cesarean section deliveries not following induction (AOR=1.26, 95% CI=1.19, 1.33), and 31% higher for cesarean section deliveries following induction (AOR=1.31, 95% CI=1.18, 1.45) than for noninduced vaginal deliveries. Lower gestational age and neonatal morbidities did not appear to be important underlying pathways. The associations were insensitive to alternative model specifications and across subpopulations. These results suggest that, in low-risk pregnancies, up to 10% of autism spectrum disorder cases are potentially preventable by avoiding cesarean section deliveries. CONCLUSIONS After accounting for medical risks, elective deliveries-particularly cesarean section deliveries-were associated with a substantially increased risk of autism spectrum disorder.
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Martinson ML, Lapham J, Ercin-Swearinger H, Teitler JO, Reichman NE. Generational Shifts in Young Adult Cardiovascular Health? Millennials and Generation X in the United States and England. J Gerontol B Psychol Sci Soc Sci 2022; 77:S177-S188. [PMID: 35195713 PMCID: PMC9154229 DOI: 10.1093/geronb/gbac036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVES To compare cardiovascular (CV) risks/conditions of Millennials (born 1981-1996) to those of Generation X (Gen X; born 1965-1980) at ages 20-34 years, across 2 countries (United States, England), by gender. METHODS Using data from the National Health and Nutrition Examination Survey (United States) and Health Survey for England, we estimated weighted unadjusted and adjusted gender-specific proportions of CV risk factors/conditions, separately for Millennials and Generation X in each country. We also further calculated sex-specific generational differences in CV risk factor/conditions by income tercile and for individuals with normal body weight. RESULTS Millennials in the United States were more obese compared to their Gen X counterparts and more likely to have diabetes risk but less likely to smoke or have high cholesterol. Millennials in England had higher diabetes risk but similar or lower rates of other CV risk/conditions compared to their Gen X counterparts. Generational changes could not be fully attributed to increases in obesity or decreases in income. DISCUSSION We expected that Millennial CV risk factors/conditions would be worse than those of Gen X, particularly in the United States, because Millennials came of age during the Great Recession and a period of increasing population obesity. Millennials generally fared worse than their Gen X counterparts in terms of obesity and diabetes risk, especially in the United States, but had lower rates of smoking and high cholesterol in both countries. Secular trends of increasing obesity and decreased economic opportunities did not appear to lead to uniform generational differences in CV risk factors.
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Mooney SJ, Bader MD, Lovasi GS, Neckerman KM, Rundle AG, Teitler JO. Using universal kriging to improve neighborhood physical disorder measurement. SOCIOLOGICAL METHODS & RESEARCH 2020; 49:1163-1185. [PMID: 34354317 PMCID: PMC8330519 DOI: 10.1177/0049124118769103] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ordinary kriging, a spatial interpolation technique, is commonly used in social sciences to estimate neighborhood attributes such as physical disorder. Universal kriging, developed and used in physical sciences, extends ordinary kriging by supplementing the spatial model with additional covariates. We measured physical disorder on 1,826 sampled block faces across 4 US cities (New York, Philadelphia, Detroit, and San Jose) using Google Street View imagery. We then compared leave-one-out cross-validation accuracy between universal and ordinary kriging and used random subsamples of our observed data to explore whether universal kriging could provide equal measurement accuracy with less spatially dense samples. Universal kriging did not always improve accuracy. However, a measure of housing vacancy did improve estimation accuracy in Philadelphia and Detroit (7.9 and 6.8% lower root mean square error, respectively) and allowed for equivalent estimation accuracy with half the sampled points in Philadelphia. Universal kriging may improve neighborhood measurement.
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Teitler JO, Plaza R, Hegyi T, Kruse L, Reichman NE. Elective Deliveries and Neonatal Outcomes in Full-Term Pregnancies. Am J Epidemiol 2019; 188:674-683. [PMID: 30698621 DOI: 10.1093/aje/kwz014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/13/2019] [Accepted: 01/14/2019] [Indexed: 11/12/2022] Open
Abstract
Cesarean and induced delivery rates have risen substantially in recent decades and currently account for over one-third and one-fourth of US births, respectively. Initiatives to encourage delaying deliveries until a gestational age of 39 weeks appear to have slowed the increases but have not led to declines. The rates are at historic highs and the consequences of these interventions when not medically necessary have not been systematically explored at the population level. In this study, we used population-level data on births in New Jersey (1997-2011) to document trends in elective deliveries (induced vaginal delivery, cesarean delivery with no labor trial, and cesarean delivery after induction) and estimate logistic and linear regression models of associations between delivery method and neonatal morbidities and cost-related outcomes in low-risk pregnancies. We found that elective deliveries more than doubled during the observation period and were associated with neonatal morbidities and cost-related outcomes even at gestational ages of 39 and 40 weeks. Findings suggest that delaying beyond 39 weeks and avoiding delivery interventions when not medically necessary would improve infant health and reduce health-care costs.
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Kane JB, Teitler JO, Reichman NE. Ethnic enclaves and birth outcomes of immigrants from India in a diverse U.S. state. Soc Sci Med 2018; 209:67-75. [PMID: 29800770 PMCID: PMC11263911 DOI: 10.1016/j.socscimed.2018.05.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 01/08/2023]
Abstract
Sociological theory suggests that ethnic enclaves promote immigrant health. Existing studies of ethnic enclaves and immigrant birth outcomes have generally focused on blacks and Hispanics, while few have focused on immigrants from India - the second largest immigrant group in the U.S., after Mexicans. Paradoxically, this group generally exhibits worse birth outcomes than non-Hispanic whites, despite their high levels of education. This study investigates associations between residence in South Central Asian ethnic enclaves and both birth outcomes and prenatal behaviors of immigrant mothers from India, using population-level birth record data from the state of New Jersey in the U.S. (1999-2012; n = 64,375). Results indicate that residence in a South Central Asian enclave is associated with less prenatal smoking and earlier prenatal care, but not with birthweight- or gestational-age related outcomes, among immigrant mothers from India. These findings are consistent with theory suggesting that social support, social capital, and social norms transmitted through the social networks present in ethnic enclaves foster health-promoting behaviors. Notably, the prenatal behaviors of non-Hispanic white mothers were not associated to a large degree with living in South Central Asian enclaves, which is also consistent with theory and bolsters our confidence that the observed associations for immigrant mothers from India are not spurious.
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Martinson ML, Tienda M, Teitler JO. Low birthweight among immigrants in Australia, the United Kingdom, and the United States. Soc Sci Med 2017; 194:168-176. [PMID: 29102737 PMCID: PMC11734628 DOI: 10.1016/j.socscimed.2017.09.043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/23/2017] [Accepted: 09/26/2017] [Indexed: 11/17/2022]
Abstract
Immigrant women are less likely than their native-born counterparts to give birth to a low birthweight infant in the United States, and length of U.S. residence shrinks nativity differences in rates of low birthweight. Yet, we know little about how the U.S. context compares to immigrant low birthweight patterns in other countries. Using nationally representative data, we examine variations in the association between nativity and low birthweight in Australia, the United Kingdom, and the United States-three economically developed countries with long immigrant traditions, but different admission regimes. This study uses birth cohort data from these three destination countries to compare low birthweight between immigrant and native-born residents and then investigates how immigrant low birthweight varies by country of origin and duration in the host country. We find no significant difference in low birthweight between immigrants and native Australians, but for the United Kingdom, we find patterns of low birthweight by duration consistent with those found in the United States. Specifically, foreign-born status protects against low birthweight, though not uniformly across racial groups, except for new arrivals. The results suggest that low birthweight among immigrants is a product of several country-specific factors, including rates of low birthweight in sending countries, access to health services in host countries, and immigrant admission policies that advantage skilled migrants.
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Mooney SJ, Bader MDM, Lovasi GS, Teitler JO, Koenen KC, Aiello AE, Galea S, Goldmann E, Sheehan DM, Rundle AG. Street Audits to Measure Neighborhood Disorder: Virtual or In-Person? Am J Epidemiol 2017; 186:265-273. [PMID: 28899028 PMCID: PMC5860155 DOI: 10.1093/aje/kwx004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 10/14/2016] [Indexed: 12/27/2022] Open
Abstract
Neighborhood conditions may influence a broad range of health indicators, including obesity, injury, and psychopathology. In particular, neighborhood physical disorder-a measure of urban deterioration-is thought to encourage crime and high-risk behaviors, leading to poor mental and physical health. In studies to assess neighborhood physical disorder, investigators typically rely on time-consuming and expensive in-person systematic neighborhood audits. We compared 2 audit-based measures of neighborhood physical disorder in the city of Detroit, Michigan: One used Google Street View imagery from 2009 and the other used an in-person survey conducted in 2008. Each measure used spatial interpolation to estimate disorder at unobserved locations. In total, the virtual audit required approximately 3% of the time required by the in-person audit. However, the final physical disorder measures were significantly positively correlated at census block centroids (r = 0.52), identified the same regions as highly disordered, and displayed comparable leave-one-out cross-validation accuracy. The measures resulted in very similar convergent validity characteristics (correlation coefficients within 0.03 of each other). The virtual audit-based physical disorder measure could substitute for the in-person one with little to no loss of precision. Virtual audits appear to be a viable and much less expensive alternative to in-person audits for assessing neighborhood conditions.
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Mooney SJ, Bader MDM, Lovasi GS, Teitler JO, Koenen KC, Aiello AE, Galea S, Goldmann E, Sheehan DM, Rundle AG. Mooney et al. Respond to "Observing Neighborhood Physical Disorder". Am J Epidemiol 2017; 186:278-279. [PMID: 28899030 PMCID: PMC5860515 DOI: 10.1093/aje/kwx006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/22/2016] [Indexed: 11/13/2022] Open
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Ostfeld BM, Schwartz-Soicher O, Reichman NE, Teitler JO, Hegyi T. Prematurity and Sudden Unexpected Infant Deaths in the United States. Pediatrics 2017; 140:peds.2016-3334. [PMID: 28759397 DOI: 10.1542/peds.2016-3334] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/03/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Prematurity, a strong risk factor for sudden unexpected infant death (SUID), was addressed in recommendations by the American Academy of Pediatrics in 2011 for safe sleep education in NICUs. We documented associations between gestational age (GA) and SUID subsequent to these guidelines. METHODS Using the 2012-2013 US linked infant birth and death certificate period files, we documented rates per live births of sudden infant death syndrome, ill-defined and unspecified causes, accidental suffocation and strangulation in bed, and overall SUID by GA in postneonatal, out-of-hospital, and autopsied cases; compared survivors and cases; and estimated logistic regression models of associations between GA and SUID. RESULTS SUID cases were more likely than survivors to be <37 weeks' GA (22.61% vs 10.79%; P < .0001). SUID rates were 2.68, 1.94, 1.46, 1.16, 0.73, and 0.51 per 1000 live births for 24 to 27, 28 to 31, 32 to 33, 34 to 36, 37 to 38, and 39 to 42 weeks' GA, respectively. Logistic regression models additionally indicated declines in the risk for SUID as GA increased. Prenatal smoking, inadequate prenatal care, and demographics associated with poverty were strongly associated with SUID. CONCLUSIONS Despite the 2011 American Academy of Pediatrics recommendations for increased safe sleep education in the NICUs, SUID rates were inversely associated with GA in 2012 to 2013, suggesting that risk of SUID associated with prematurity has multiple etiologies requiring continued investigation, including biological vulnerabilities and the efficacy of NICU education programs, and that strategies to reduce SUID should be multifaceted.
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Martinson ML, Teitler JO, Plaza R, Reichman NE. Income disparities in cardiovascular health across the lifespan. SSM Popul Health 2016; 2:904-913. [PMID: 29349197 PMCID: PMC5757909 DOI: 10.1016/j.ssmph.2016.10.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Revised: 10/13/2016] [Accepted: 10/21/2016] [Indexed: 01/04/2023] Open
Abstract
Using data from the 1999-2014 National Health and Nutrition Examination Survey (n ~ 46,000), this study documents income disparities in the age patterning of cardiovascular conditions across the lifespan in the U.S. The conditions were assessed from laboratory test results, self-reports of medications used to treat specific conditions, and anthropometric measurements, allowing us to capture whether individuals at given ages had developed the various conditions, regardless of previous diagnosis and treatment. We found evidence of large income disparities in the presence of cardiovascular conditions and risk factors for females, smaller disparities in the same conditions for males, and few disparities that increased with age for either gender. Results were very similar when considering disparities by education instead of income. The findings suggest that the widening socioeconomic gradients in health over the lifespan found in many previous studies-which have generally focused on self-rated health, activity limitations, or diagnosed conditions-reflect, at least to some extent, differences in diagnosis, treatment, and management of health conditions rather than age-related differences in developing them. The findings also suggest that preventive healthcare is not an important source of socioeconomic disparities in cardiovascular health in the U.S., at least for men. The observed patterns of income disparities in cardiovascular conditions over the lifespan are more consistent with theories of early life conditions and the imprinting of health endowments and susceptibilities early in life than with cumulative life exposure or stress hypotheses.
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Mooney SJ, DiMaggio CJ, Lovasi GS, Neckerman KM, Bader MDM, Teitler JO, Sheehan DM, Jack DW, Rundle AG. Use of Google Street View to Assess Environmental Contributions to Pedestrian Injury. Am J Public Health 2016; 106:462-9. [PMID: 26794155 DOI: 10.2105/ajph.2015.302978] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To demonstrate an information technology-based approach to assess characteristics of streets and intersections associated with injuries that is less costly and time-consuming than location-based studies of pedestrian injury. METHODS We used imagery captured by Google Street View from 2007 to 2011 to assess 9 characteristics of 532 intersections within New York City. We controlled for estimated pedestrian count and estimated the relation between intersections' characteristics and frequency of injurious collisions. RESULTS The count of pedestrian injuries at intersections was associated with the presence of marked crosswalks (80% increase; 95% confidence interval [CI] = 2%, 218%), pedestrian signals (156% increase; 95% CI = 69%, 259%), nearby billboards (42% increase; 95% CI = 7%, 90%), and bus stops (120% increase; 95% CI = 51%, 220%). Injury incidence per pedestrian was lower at intersections with higher estimated pedestrian volumes. CONCLUSIONS Consistent with in-person study observations, the information-technology approach found traffic islands, visual advertising, bus stops, and crosswalk infrastructures to be associated with elevated counts of pedestrian injury in New York City. Virtual site visits for pedestrian injury control studies are a viable and informative methodology.
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Bader MDM, Mooney SJ, Lee YJ, Sheehan D, Neckerman KM, Rundle AG, Teitler JO. Development and deployment of the Computer Assisted Neighborhood Visual Assessment System (CANVAS) to measure health-related neighborhood conditions. Health Place 2014; 31:163-72. [PMID: 25545769 DOI: 10.1016/j.healthplace.2014.10.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 09/23/2014] [Accepted: 10/28/2014] [Indexed: 11/15/2022]
Abstract
Public health research has shown that neighborhood conditions are associated with health behaviors and outcomes. Systematic neighborhood audits have helped researchers measure neighborhood conditions that they deem theoretically relevant but not available in existing administrative data. Systematic audits, however, are expensive to conduct and rarely comparable across geographic regions. We describe the development of an online application, the Computer Assisted Neighborhood Visual Assessment System (CANVAS), that uses Google Street View to conduct virtual audits of neighborhood environments. We use this system to assess the inter-rater reliability of 187 items related to walkability and physical disorder on a national sample of 150 street segments in the United States. We find that many items are reliably measured across auditors using CANVAS and that agreement between auditors appears to be uncorrelated with neighborhood demographic characteristics. Based on our results we conclude that Google Street View and CANVAS offer opportunities to develop greater comparability across neighborhood audit studies.
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Quinn JW, Mooney SJ, Sheehan DM, Teitler JO, Neckerman KM, Kaufman TK, Lovasi GS, Bader MDM, Rundle AG. Neighborhood Physical Disorder in New York City. JOURNAL OF MAPS 2014; 12:53-60. [PMID: 27482283 PMCID: PMC4963033 DOI: 10.1080/17445647.2014.978910] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 10/02/2014] [Accepted: 10/03/2014] [Indexed: 05/22/2023]
Abstract
Neighborhood physical disorder, or the deterioration of urban environments, is associated with negative mental and physical health outcomes. Eleven trained raters used CANVAS, a web-based system for conducting reliable virtual street audits, to collect data on nine indicators of physical disorder using Google Street View imagery of 532 block faces in New York City, New York, USA. We combined the block face indicator data into a disorder scale using item response theory; indicators ranged in severity from presence of litter, a weak indicator of disorder, to abandoned cars, a strong indicator. Using this scale, we estimated disorder at the center point of each sampled block. We then used ordinary kriging to interpolate estimates of disorder levels throughout the city. The resulting map condenses a complex estimation process into an interpretable visualization of the spatial distribution of physical disorder in New York City.
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Mooney SJ, Bader MDM, Lovasi GS, Neckerman KM, Teitler JO, Rundle AG. Validity of an ecometric neighborhood physical disorder measure constructed by virtual street audit. Am J Epidemiol 2014; 180:626-35. [PMID: 25122584 DOI: 10.1093/aje/kwu180] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Neighborhood physical disorder is thought to affect mental and physical health, but it has been difficult to measure objectively and reliably across large geographical areas or multiple locales. Virtual street audits are a novel method for assessing neighborhood characteristics. We evaluated the ecometric properties of a neighborhood physical disorder measure constructed from virtual street audit data. Eleven trained auditors assessed 9 previously validated items developed to capture physical disorder (e.g., litter, graffiti, and abandoned buildings) on 1,826 block faces using Google Street View imagery (Google, Inc., Mountain View, California) dating from 2007-2011 in 4 US cities (San Jose, California; Detroit, Michigan; New York, New York; and Philadelphia, Pennsylvania). We constructed a 2-parameter item response theory scale to estimate latent levels of disorder on each block face and defined a function using kriging to estimate physical disorder levels, with confidence estimates, for any point in each city. The internal consistency reliability of the resulting scale was 0.93. The final measure of disorder was positively correlated with US Census data on unemployment and housing vacancy and negatively correlated with data on owner-occupied housing. These results suggest that neighborhood physical disorder can be measured reliably and validly using virtual audits, facilitating research on possible associations between physical disorder and health.
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Hansen HB, Donaldson Z, Link BG, Bearman PS, Hopper K, Bates LM, Cheslack-Postava K, Harper K, Holmes SM, Lovasi G, Springer KW, Teitler JO. Independent review of social and population variation in mental health could improve diagnosis in DSM revisions. Health Aff (Millwood) 2013; 32:984-93. [PMID: 23614899 DOI: 10.1377/hlthaff.2011.0596] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
At stake in the May 2013 publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), are billions of dollars in insurance payments and government resources, as well as the diagnoses and treatment of millions of patients. We argue that the most recent revision process has missed social determinants of mental health disorders and their diagnosis: environmental factors triggering biological responses that manifest themselves in behavior; differing cultural perceptions about what is normal and what is abnormal behavior; and institutional pressures related to such matters as insurance reimbursements, disability benefits, and pharmaceutical marketing. In addition, the experts charged with revising the DSM lack a systematic way to take population-level variations in diagnoses into account. To address these problems, we propose the creation of an independent research review body that would monitor variations in diagnostic patterns, inform future DSM revisions, identify needed changes in mental health policy and practice, and recommend new avenues of research. Drawing on the best available knowledge, the review body would make possible more precise and equitable psychiatric diagnoses and interventions.
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Reichman NE, Teitler JO. Lifecourse Exposures and Socioeconomic Disparities in Child Health. NATIONAL SYMPOSIUM ON FAMILY ISSUES 2013. [DOI: 10.1007/978-1-4614-6194-4_9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Teitler JO, Hutto N, Reichman NE. Birthweight of children of immigrants by maternal duration of residence in the United States. Soc Sci Med 2012; 75:459-68. [PMID: 22580075 PMCID: PMC3388036 DOI: 10.1016/j.socscimed.2012.03.038] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2011] [Revised: 03/16/2012] [Accepted: 03/27/2012] [Indexed: 11/23/2022]
Abstract
A large literature on immigrant health in the U.S. has shown that immigrants tend to be healthier and live longer than both individuals who remain in their countries of origin and natives of their host countries who are of the same race or ethnicity. However, this immigrant health advantage appears to diminish with duration of residence in the U.S. Few studies of the effects of immigrants' exposure to the U.S. have focused on perinatal health. This study used three contemporary national datasets to describe patterns in infant birthweight by maternal duration of residence in the U.S. For both immigrants overall and Hispanic immigrants in particular, rates of low birthweight appeared to decline over the first few years in the U.S. and increase thereafter. This curvilinear association was robust across the three datasets and deviates somewhat from the prevailing notion that immigrant health declines monotonically over time. Additionally, we found no evidence that prenatal substance use increased with duration of residence in the U.S.
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Teitler JO, Das D, Kruse L, Reichman NE. Prenatal care and subsequent birth intervals. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2012; 44:13-21. [PMID: 22405147 PMCID: PMC3733565 DOI: 10.1363/4401312] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
CONTEXT Prenatal care generally includes contraceptive and health education that may help women to control their subsequent fertility. However, research has not examined whether receipt of prenatal care is associated with subsequent birthspacing. METHODS Longitudinally linked birth records from 113,662 New Jersey women who had had a first birth in 1996-2000 were used to examine associations between the timing and adequacy of prenatal care prior to a woman's first birth and the timing of her second birth. Multinomial logistic regression analyses adjusted for social and demographic characteristics, hospital and year of birth. RESULTS Most women (85%) had initiated prenatal care during the first trimester. Women who had not obtained prenatal care until the second or third trimester, or at all, were more likely than those who had had first-trimester care to have a second child within 18 months, rather than in 18-59 months (odds ratios, 1.2-1.6). Similarly, women whose care had been inadequate were more likely than those who had had adequate care to have a short subsequent birth interval (1.2). The associations were robust to alternative measures of prenatal care and birth intervals, and were strongest for mothers with less than 16 years of education. CONCLUSIONS Providers should capitalize on their limited encounters with mothers who initiate prenatal care late or use it sporadically to ensure that these women receive information about family planning.
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Hamilton ER, Teitler JO, Reichman NE. Mexican American birthweight and child overweight: unraveling a possible early life course health transition. JOURNAL OF HEALTH AND SOCIAL BEHAVIOR 2011; 52:333-48. [PMID: 21788453 PMCID: PMC3733561 DOI: 10.1177/0022146511405335] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Mexican American children have a weight distribution that categorizes them as relatively healthy at birth but relatively unhealthy by age 3. This early life course transition in health based on weight raises the question of whether Mexican American children "outgrow" the epidemiologic paradox of favorable birth outcomes despite social disadvantage or whether their birthweight distribution places them on trajectory for overweight in childhood. We address this question using newly available 9-year follow-up data from the Fragile Families and Child Wellbeing birth cohort study linked to pre-natal medical records. We systematically investigate the roles of birthweight, pre-natal factors, and childhood factors in explaining racial/ethnic differences in childhood overweight. Our main finding is that Mexican American children do outgrow the paradox: Their rates of childhood overweight are higher than expected given their birthweight distribution. Observed pre-natal and childhood factors do not explain the elevated rates of overweight among Mexican American children.
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Martinson ML, Teitler JO, Reichman NE. Health across the life span in the United States and England. Am J Epidemiol 2011; 173:858-65. [PMID: 21389038 DOI: 10.1093/aje/kwq325] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
This study systematically compared health indicators in the United States and England from childhood through old age (ages 0-80 years). Data were from the 1999-2006 National Health and Nutrition Examination Survey for the United States (n = 39,849) and the 2003-2006 Health Survey for England (n = 69,084). Individuals in the United States have higher rates of most chronic diseases and markers of disease than their same-age counterparts in England. Differences at young ages are as large as those at older ages for most conditions, including obesity, low high-density lipoprotein cholesterol, high cholesterol ratio, high C-reactive protein, hypertension (for females), diabetes, asthma, heart attack or angina (for females), and stroke (for females). For males, heart attack or angina is higher in the United States only at younger ages, and hypertension is higher in England than in the United States at young ages. The patterns were similar when the sample was restricted to whites, the insured, nonobese, nonsmoking nondrinkers, and specific income categories and when stratified by normal weight, overweight, and obese weight categories. The findings from this study indicate that US health disadvantages compared with England arise at early ages and that differences in the body weight distributions of the 2 countries do not play a clear role.
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