US Urban Teachers' Perspectives of Culturally Competent Professional Development

ERIC Educational Resources Information Center

Flory, Sara B.; McCaughtry, Nate; Martin, Jeffrey J.; Murphy, Anne; Blum, Barbara; Wisdom, Kimberlydawn

2014-01-01

Health disparities related to food choices, nutrition behaviours and smoking habits in urban communities in the United States signal the importance of health education (HE) in schools, yet educators in urban communities face unique cultural challenges often unaddressed in professional development (PD). The purpose of this study was to use a…

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014.

PubMed

Guo, Lijun; Bao, Yong; Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction.

Quality of community basic medical service utilization in urban and suburban areas in Shanghai from 2009 to 2014

PubMed Central

Ma, Jun; Li, Shujun; Cai, Yuyang; Sun, Wei; Liu, Qiaohong

2018-01-01

Urban areas usually display better health care services than rural areas, but data about suburban areas in China are lacking. Hence, this cross-sectional study compared the utilization of community basic medical services in Shanghai urban and suburban areas between 2009 and 2014. These data were used to improve the efficiency of community health service utilization and to provide a reference for solving the main health problems of the residents in urban and suburban areas of Shanghai. Using a two-stage random sampling method, questionnaires were completed by 73 community health service centers that were randomly selected from six districts that were also randomly selected from 17 counties in Shanghai. Descriptive statistics, principal component analysis, and forecast analysis were used to complete a gap analysis of basic health services utilization quality between urban and suburban areas. During the 6-year study period, there was an increasing trend toward greater efficiency of basic medical service provision, benefits of basic medical service provision, effectiveness of common chronic disease management, overall satisfaction of community residents, and two-way referral effects. In addition to the implementation effect of hypertension management and two-way referral, the remaining indicators showed a superior effect in urban areas compared with the suburbs (P<0.001). In addition, among the seven principal components, four principal component scores were better in urban areas than in suburban areas (P = <0.001, 0.004, 0.036, and 0.022). The urban comprehensive score also exceeded that of the suburbs (P<0.001). In summary, over the 6-year period, there was a rapidly increasing trend in basic medical service utilization. Comprehensive satisfaction clearly improved as well. Nevertheless, there was an imbalance in health service utilization between urban and suburban areas. There is a need for the health administrative department to address this imbalance between urban and suburban institutions and to provide the required support to underdeveloped areas to improve resident satisfaction. PMID:29791470

Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012

PubMed Central

Holbrook, Joseph R.; Bitsko, Rebecca H.; Hartwig, Sophie A.; Kaminski, Jennifer W.; Ghandour, Reem M.; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A.

2017-01-01

Problem/Condition Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. Reporting Period 2011–2012. Description of System The National Survey of Children’s Health (NSCH) is a cross-sectional, random-digit–dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States. Interviews included indicators of health and well-being, health care access, and family and community characteristics. Using data from the 2011–2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2–8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2–8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. Results A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. Interpretation Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. Public Health Action Collaboration involving health care, family, and community services and systems can be used to address fragmented services and supports for children with MBDDs, regardless of whether they live in urban or rural areas. However, addressing differences in health care, family, and community factors and leveraging community strengths among children who live in rural areas present opportunities to promote health among children in rural communities. PMID:28301449

Promoting Ethical Research With American Indian and Alaska Native People Living in Urban Areas

PubMed Central

Bartgis, Jami; Demers, Deirdre

2014-01-01

Most health research with American Indian and Alaska Native (AI/AN) people has focused on tribal communities on reservation lands. Few studies have been conducted with AI/AN people living in urban settings despite their documented health disparities compared with other urban populations. There are unique considerations for working with this population. Engaging key stakeholders, including urban Indian health organization leaders, tribal leaders, research scientists and administrators, and policymakers, is critical to promoting ethical research and enhancing capacity of urban AI/AN communities. Recommendations for their involvement may facilitate an open dialogue and promote the development of implementation strategies. Future collaborations are also necessary for establishing research policies aimed at improving the health of the urban AI/AN population. PMID:25211730

The Urban Context: A Place to Eliminate Health Disparities and Build Organizational Capacity

PubMed Central

GILBERT, KEON L.; QUINN, SANDRA CROUSE; FORD, ANGELA F.; THOMAS, STEPHEN B.

2011-01-01

This study seeks to examine the process of building the capacity to address health disparities in several urban African American neighborhoods. An inter-organizational network consisting of a research university, community members, community organizations, media partners, and foundations was formed to develop a community-based intervention designed to provide health promotion and disease prevention strategies for type 2 diabetes and hypertension. In-depth qualitative interviews (n = 18) with foundation executives and project directors, civic organization leadership, community leaders, county epidemiologist, and university partners were conducted. Our study contextualizes a process to build a public health partnership using cultural, community, organizational, and societal factors necessary to address health disparities. Results showed 5 important factors to build organizational capacity: leadership, institutional commitment, trust, credibility, and inter-organizational networks. These factors reflected other important organizational and community capacity indicators such as: community context, organizational policies, practices and structures, and the establishment of new commitments and partnerships important to comprehensively address urban health disparities. Understanding these factors to address African American health disparities will provide lessons learned for health educators, researchers, practitioners, foundations, and communities interested in building and sustaining capacity efforts through the design, implementation, and maintenance of a community-based health promotion intervention. PMID:21271434

Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2-8 Years in Rural and Urban Areas - United States, 2011-2012.

PubMed

Robinson, Lara R; Holbrook, Joseph R; Bitsko, Rebecca H; Hartwig, Sophie A; Kaminski, Jennifer W; Ghandour, Reem M; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A

2017-03-17

Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. 2011-2012. The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged <18 years in the United States. Interviews included indicators of health and well-being, health care access, and family and community characteristics. Using data from the 2011-2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2-8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2-8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural subtypes, children with an MBDD more often lacked a medical home, had a parent with poor mental health, lived in families with financial difficulties, and lived in a neighborhood lacking physical and social resources than children without an MBDD within each of those community types. Only in urban areas did a higher percentage of children with MBDDs lack health insurance than children without MBDDs. After adjusting for race/ethnicity and poverty among children with MBDDs, those in rural areas more often had a parent with poor mental health and lived in resource-low neighborhoods than those in urban areas. Certain health care, family, and community disparities were more often reported among children with MBDDS than among children without MBDDs in rural and urban areas. Collaboration involving health care, family, and community services and systems can be used to address fragmented services and supports for children with MBDDs, regardless of whether they live in urban or rural areas. However, addressing differences in health care, family, and community factors and leveraging community strengths among children who live in rural areas present opportunities to promote health among children in rural communities.

Youth empowerment through urban agriculture: Red Hook Community Farm

Treesearch

Ian Marvy

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Contextual variations in costs for a community health strategy implemented in rural, peri-urban and nomadic sites in Kenya.

PubMed

Wafula, Charles Ouma; Edwards, Nancy; Kaseje, Dan C O

2017-02-28

Many low and middle income countries have developed community health strategies involving lay health workers, to complement and strengthen public health services. This study explores variations in costing parameters pertinent to deployment of community health volunteers across different contexts outlining considerations for costing program scale-up. The study used quasi experimental study design and employed both quantitative and qualitative methods to explore community health unit implementation activities and costs and compare costs across purposively selected sites that differed socially, economically and ecologically. Data were collected from November 2010 to December 2013 through key informant interviews and focus group discussions. We interviewed 16 key informants (eight District community health strategy focal persons, eight frontline field officers), and eight focus group discussions (four with community health volunteers and four with community health committee) and 560 sets of monthly cost data. Cost data were tabulated using Microsoft Excel. Qualitative data were transcribed and coded using a content analysis framework. Four critical elements: attrition rates for community health volunteers, geography and population density, livelihood opportunity costs and benefits, and social opportunity benefits, drove cost variations across the three sites. Attrition rate was highest in peri-urban site where population is highly mobile and lowest in nomadic site. More households were covered by community health workers in the peri-urban area making per capita costs considerably less than in the nomadic settings where long distances had to be covered to reach sparsely distributed households. Livelihood opportunity costs for Community Health Volunteers were highest in nomadic setting, while peri-urban ones reported substantial employability benefits resulting from training. Social opportunity benefits were highest in rural site. Results show that costs of implementing community health strategy varied due to different area contextual factors in Kenya. This study identified four critical elements that drive cost variations: attrition rates for community health volunteers, geography and population density, livelihood opportunity costs and benefits, and social opportunity benefits. Health programme managers and policy-makers need to pay attention to details of contextual factors in costing for effective implementation of community health strategies.

Generating global political priority for urban health: the role of the urban health epistemic community.

PubMed

Shawar, Yusra Ribhi; Crane, Lani G

2017-10-01

Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community's ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

The impact of community context on children's health and nutritional status in China.

PubMed

Lei, Lei

2017-04-01

The link between community environment and individual health outcomes has been widely documented in Western literature, but little is known about whether community context influences children's health over and above individual characteristics in developing countries. This study examines how community socioeconomic status (SES) influences children's self-rated health and nutritional status in urban and rural China and explores whether the effects of community SES vary by a child's gender and family background. Using data from the China Family Penal Studies in 2010, this study focuses on children aged 10-15 years old living in 261 urban neighborhoods and 293 rural villages in China. Multilevel regression models are estimated to examine the effect of community SES on the probability of reporting poor/fair health and nutritional status measured by height for age while controlling for individual and family characteristics. The results suggest that community SES has a positive and curvilinear effect on children's health and nutritional status in urban China, and it only positively influences children's nutrition in rural China. Community SES has a stronger effect for boys than for girls, and for children in poorer families and families with lower levels of parental involvement. Copyright © 2017 Elsevier Ltd. All rights reserved.

Accessing the Food Systems in Urban and Rural Minnesotan Communities

ERIC Educational Resources Information Center

Smith, Chery; Miller, Hannah

2011-01-01

Objective: Explore how urban and rural Minnesotans access the food system and to investigate whether community infrastructure supports a healthful food system. Design: Eight (4 urban and 4 rural) focus groups were conducted. Setting and Participants: Eight counties with urban influence codes of 1, 2, 4, 5, 8, and 10. Fifty-nine (urban, n = 27;…

Incorporating Traditional Healing into an Urban American Indian Health Organization: A Case Study of Community Member Perspectives

ERIC Educational Resources Information Center

Hartmann, William E.; Gone, Joseph P.

2012-01-01

Facing severe mental health disparities rooted in a complex history of cultural oppression, members of many urban American Indian (AI) communities are reaching out for indigenous traditional healing to augment their use of standard Western mental health services. Because detailed descriptions of approaches for making traditional healing available…

Assessing resources for implementing a community directed intervention (CDI) strategy in delivering multiple health interventions in urban poor communities in Southwestern Nigeria: a qualitative study.

PubMed

Ajayi, Ikeoluwapo O; Jegede, Ayodele S; Falade, Catherine O; Sommerfeld, Johannes

2013-10-24

Many simple, affordable and effective disease control measures have had limited impact due to poor access especially by the poorer populations (urban and rural) and inadequate community participation. A proven strategy to address the problem of access to health interventions is the Community Directed Interventions (CDI) approach, which has been used successfully in rural areas. This study was carried out to assess resources for the use of a CDI strategy in delivering health interventions in poorly-served urban communities in Ibadan, Nigeria. A formative study was carried out in eight urban poor communities in the Ibadan metropolis in the Oyo State. Qualitative methods comprising 12 focus group discussions (FGDs) with community members and 73 key informant interviews (KIIs) with community leaders, programme managers, community-based organisations (CBOs), non-government organisations (NGOs) and other stakeholders at federal, state and local government levels were used to collect data to determine prevalent diseases and healthcare delivery services, as well as to explore the potential resources for a CDI strategy. All interviews were audio recorded. Content analysis was used to analyse the data. Malaria, upper respiratory tract infection, diarrhoea and measles were found to be prevalent in children, while hypertension and diabetes topped the list of diseases among adults. Healthcare was financed mainly by out-of-pocket expenses. Cost and location were identified as hindrances to utilisation of health facilities; informal cooperatives (esusu) were available to support those who could not pay for care. Immunisation, nutrition, reproductive health, tuberculosis (TB) and leprosy, environmental health, malaria and HIV/AIDs control programmes were the ongoing interventions. Delivery strategies included house-to-house, home-based treatment, health education and campaigns. Community participation in the planning, implementation and monitoring of development projects was reported as common practice. The resources available for these activities and which constitute potential resources for the CDI process include community volunteers, CBOs and NGOs. Others are landlords; professional, women and youth associations; social clubs, religious organisations and the available health facilities. This study's findings support the feasibility of using the CDI process in delivering health interventions in urban poor communities and show that potential resources for the strategy abound in the communities.

Asthma patient education opportunities in predominantly minority urban communities.

PubMed

Zayas, Luis E; McLean, Don

2007-12-01

Disenfranchised ethnic minority communities in the urban United States experience a high burden of asthma. Conventional office-based patient education often is insufficient to promote proper asthma management and coping practices responsive to minority patients' environments. This paper explores existing and alternative asthma information and education sources in three urban minority communities in western New York State to help design other practical educational interventions. Four focus groups (n = 59) and four town hall meetings (n = 109) were conducted in one Hispanic and two black communities. Focus groups included adult asthmatics or caretakers of asthmatics, and town meetings were open to all residents. A critical theory perspective informed the study. Asthma information and education sources, perceptions of asthma and ways of coping were elicited through semi-structured interviews. Data analysis followed a theory-driven immersion-crystallization approach. Several asthma education and information resources from the health care system, media, public institutions and communities were identified. Intervention recommendations highlighted asthma workshops that recognize participants as teachers and learners, offer social support, promote advocacy, are culturally appropriate and community-based and include health care professionals. Community-based, group health education couched on people's experiences and societal conditions offers unique opportunities for patient asthma care empowerment in minority urban communities.

Conducting Research With Community Groups.

PubMed

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2015-10-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. Although several barriers to conducting research with community groups exist, community-based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This article presents case studies that demonstrate how CBPR principles guided the development of (a) a healthy body weight program for urban, underserved African American women; (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women; and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research-intensive academic environments. © The Author(s) 2015.

Conducting Research with Community Groups

PubMed Central

Doornbos, Mary Molewyk; Ayoola, Adejoke; Topp, Robert; Zandee, Gail Landheer

2016-01-01

Nurse scientists are increasingly recognizing the necessity of conducting research with community groups to effectively address complex health problems and successfully translate scientific advancements into the community. While several barriers to conducting research with community groups exist, community based participatory research (CBPR) has the potential to mitigate these barriers. CBPR has been employed in programs of research that respond in culturally sensitive ways to identify community needs and thereby address current health disparities. This manuscript presents case studies that demonstrate how CBPR principles guided the development of: (a) a healthy body weight program for urban, underserved African-American women, (b) a reproductive health educational intervention for urban, low-income, underserved, ethnically diverse women, and (c) a pilot anxiety/depression intervention for urban, low-income, underserved, ethnically diverse women. These case studies illustrate the potential of CBPR as an orientation to research that can be employed effectively in non-research intensive academic environments. PMID:25724557

The impact of the great recession on community-based mental health organizations: an analysis of top managers' perceptions of the economic downturn's effects and adaptive strategies used to manage the consequences in Ohio.

PubMed

Sweeney, Helen Anne; Knudsen, Kraig

2014-04-01

The Great Recession of 2007-2009 adversely affected the financial stability of the community-based mental health infrastructure in Ohio. This paper presents survey results of the type of adaptive strategies used by Ohio community-based mental health organizations to manage the consequences of the economic downturn. Results were aggregated into geographical classifications of rural, mid-sized urban, and urban. Across all groups, respondents perceived, to varying degrees, that the Great Recession posed a threat to their organization's survival. Urban organizations were more likely to implement adaptive strategies to expand operations while rural and midsized urban organizations implemented strategies to enhance internal efficiencies.

Examining urban brownfields through the public health "macroscope".

PubMed

Litt, Jill S; Tran, Nga L; Burke, Thomas A

2002-04-01

Efforts to cope with the legacy of our industrial cities--blight, poverty, environmental degradation, ailing communities--have galvanized action across the public and private sectors to move vacant industrial land, also referred to as brownfields, to productive use; to curb sprawling development outside urban areas; and to reinvigorate urban communities. Such efforts, however, may be proceeding without thorough investigations into the environmental health and safety risks associated with industrial brownfields properties and the needs of affected neighborhoods. We describe an approach to characterize vacant and underused industrial and commercial properties in Southeast Baltimore and the health and well being of communities living near these properties. The screening algorithm developed to score and rank properties in Southeast Baltimore (n= 182) showed that these sites are not benign. The historical data revealed a range of hazardous operations, including metal smelting, oil refining, warehousing, and transportation, as well as paints, plastics, and metals manufacturing. The data also identified hazardous substances linked to these properties, including heavy metals, solvents, polycyclic aromatic hydrocarbons, plasticizers, and insecticides, all of which are suspected or recognized toxicants and many of which are persistent in the environment. The health analysis revealed disparities across Southeast Baltimore communities, including excess deaths from respiratory illness (lung cancer, chronic obstructive pulmonary disease, influenza, and pneumonia), total cancers, and a "leading cause of death" index and a spatial and statistical relationship between environmentally degraded brownfields areas and at-risk communities. Brownfields redevelopment is a key component of our national efforts to address environmental justice and health disparities across urban communities and is critical to urban revitalization. Incorporating public health into brownfields-related cleanup and land-use decisions will increase the odds for successful neighborhood redevelopment and long-term public health benefits.

Examining urban brownfields through the public health "macroscope".

PubMed Central

Litt, Jill S; Tran, Nga L; Burke, Thomas A

2002-01-01

Efforts to cope with the legacy of our industrial cities--blight, poverty, environmental degradation, ailing communities--have galvanized action across the public and private sectors to move vacant industrial land, also referred to as brownfields, to productive use; to curb sprawling development outside urban areas; and to reinvigorate urban communities. Such efforts, however, may be proceeding without thorough investigations into the environmental health and safety risks associated with industrial brownfields properties and the needs of affected neighborhoods. We describe an approach to characterize vacant and underused industrial and commercial properties in Southeast Baltimore and the health and well being of communities living near these properties. The screening algorithm developed to score and rank properties in Southeast Baltimore (n= 182) showed that these sites are not benign. The historical data revealed a range of hazardous operations, including metal smelting, oil refining, warehousing, and transportation, as well as paints, plastics, and metals manufacturing. The data also identified hazardous substances linked to these properties, including heavy metals, solvents, polycyclic aromatic hydrocarbons, plasticizers, and insecticides, all of which are suspected or recognized toxicants and many of which are persistent in the environment. The health analysis revealed disparities across Southeast Baltimore communities, including excess deaths from respiratory illness (lung cancer, chronic obstructive pulmonary disease, influenza, and pneumonia), total cancers, and a "leading cause of death" index and a spatial and statistical relationship between environmentally degraded brownfields areas and at-risk communities. Brownfields redevelopment is a key component of our national efforts to address environmental justice and health disparities across urban communities and is critical to urban revitalization. Incorporating public health into brownfields-related cleanup and land-use decisions will increase the odds for successful neighborhood redevelopment and long-term public health benefits. PMID:11929727

Science-policy challenges for biodiversity, public health and urbanization: examples from Belgium

NASA Astrophysics Data System (ADS)

Keune, H.; Kretsch, C.; De Blust, G.; Gilbert, M.; Flandroy, L.; Van den Berge, K.; Versteirt, V.; Hartig, T.; De Keersmaecker, L.; Eggermont, H.; Brosens, D.; Dessein, J.; Vanwambeke, S.; Prieur-Richard, A. H.; Wittmer, H.; Van Herzele, A.; Linard, C.; Martens, P.; Mathijs, E.; Simoens, I.; Van Damme, P.; Volckaert, F.; Heyman, P.; Bauler, T.

2013-06-01

Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human-nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem-human/public health-urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed.

Revitalizing communities together: the shared values, goals, and work of education, urban planning, and public health.

PubMed

Cohen, Alison Klebanoff; Schuchter, Joseph W

2013-04-01

Inequities in education, the urban environment, and health co-exist and mutually reinforce each other. Educators, planners, and public health practitioners share commitments to place-based, participatory, youth-focused, and equitable work. They also have shared goals of building community resilience, social capital, and civic engagement. Interdisciplinary programs that embody these shared values and work towards these shared goals are emerging, including school-based health centers, full-service community schools, community health centers, Promise Neighborhoods, and Choice Neighborhoods. The intersection of these three fields represents an opportunity to intervene on social determinants of health. More collaborative research and practice across public health, education, and planning should build from the shared values identified to continue to address these common goals.

Using Health Impact Assessment as an Interdisciplinary Teaching Tool.

PubMed

Chinchilla, Melissa; Arcaya, Mariana C

2017-07-08

Health Impact Assessment (HIA) courses are teaching public health and urban planning students how to assess the likely health effects of proposed policies, plans, and projects. We suggest that public health and urban planning have complimentary frameworks for training practitioners to address the living conditions that affect health. Planning perspectives emphasize practical skills for impacting community change, while public health stresses professional purpose and ethics. Frameworks from both disciplines can enhance the HIA learning experience by helping students tackle questions related to community impact, engagement, social justice, and ethics. We also propose that HIA community engagement processes can be enriched through an empathetic practice that focuses on greater personal introspection.

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment.

PubMed

Ward Thompson, Catharine; Aspinall, Peter; Roe, Jenny; Robertson, Lynette; Miller, David

2016-04-22

Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people's stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant's home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments.

Mitigating Stress and Supporting Health in Deprived Urban Communities: The Importance of Green Space and the Social Environment

PubMed Central

Ward Thompson, Catharine; Aspinall, Peter; Roe, Jenny; Robertson, Lynette; Miller, David

2016-01-01

Environment-health research has shown significant relationships between the quantity of green space in deprived urban neighbourhoods and people’s stress levels. The focus of this paper is the nature of access to green space (i.e., its quantity or use) necessary before any health benefit is found. It draws on a cross-sectional survey of 406 adults in four communities of high urban deprivation in Scotland, United Kingdom. Self-reported measures of stress and general health were primary outcomes; physical activity and social wellbeing were also measured. A comprehensive, objective measure of green space quantity around each participant’s home was also used, alongside self-report measures of use of local green space. Correlated Component Regression identified the optimal predictors for primary outcome variables in the different communities surveyed. Social isolation and place belonging were the strongest predictors of stress in three out of four communities sampled, and of poor general health in the fourth, least healthy, community. The amount of green space in the neighbourhood, and in particular access to a garden or allotment, were significant predictors of stress. Physical activity, frequency of visits to green space in winter months, and views from the home were predictors of general health. The findings have implications for public health and for planning of green infrastructure, gardens and public open space in urban environments. PMID:27110803

Improving Urban African Americans’ Blood Pressure Control through Multi-level Interventions in the Achieving Blood Pressure Control Together (ACT) Study: A Randomized Clinical Trial

PubMed Central

Ephraim, Patti L.; Hill-Briggs, Felicia; Roter, Debra; Bone, Lee; Wolff, Jennifer; Lewis-Boyer, LaPricia; Levine, David; Aboumatar, Hanan; Cooper, Lisa A; Fitzpatrick, Stephanie; Gudzune, Kimberly; Albert, Michael; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary; Fagan, Peter; Ramamurthi, Hema; Ameling, Jessica; Charlston, Jeanne; Sam, Tanyka; Carson, Kathryn A.; Wang, Nae-Yuh; Crews, Deidra; Greer, Raquel; Sneed, Valerie; Flynn, Sarah J.; DePasquale, Nicole; Boulware, L. Ebony

2014-01-01

Background Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients’ management of a variety of chronic illnesses. However, studies of multilevel interventions designed specifically to improve urban African American patients’ blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. Methods/Design We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients’ improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients’ blood pressure control at 12 months. Discussion Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients’ hypertension control. PMID:24956323

Improving urban African Americans' blood pressure control through multi-level interventions in the Achieving Blood Pressure Control Together (ACT) study: a randomized clinical trial.

PubMed

Ephraim, Patti L; Hill-Briggs, Felicia; Roter, Debra L; Bone, Lee R; Wolff, Jennifer L; Lewis-Boyer, LaPricia; Levine, David M; Aboumatar, Hanan J; Cooper, Lisa A; Fitzpatrick, Stephanie J; Gudzune, Kimberly A; Albert, Michael C; Monroe, Dwyan; Simmons, Michelle; Hickman, Debra; Purnell, Leon; Fisher, Annette; Matens, Richard; Noronha, Gary J; Fagan, Peter J; Ramamurthi, Hema C; Ameling, Jessica M; Charlston, Jeanne; Sam, Tanyka S; Carson, Kathryn A; Wang, Nae-Yuh; Crews, Deidra C; Greer, Raquel C; Sneed, Valerie; Flynn, Sarah J; DePasquale, Nicole; Boulware, L Ebony

2014-07-01

Given their high rates of uncontrolled blood pressure, urban African Americans comprise a particularly vulnerable subgroup of persons with hypertension. Substantial evidence has demonstrated the important role of family and community support in improving patients' management of a variety of chronic illnesses. However, studies of multi-level interventions designed specifically to improve urban African American patients' blood pressure self-management by simultaneously leveraging patient, family, and community strengths are lacking. We report the protocol of the Achieving Blood Pressure Control Together (ACT) study, a randomized controlled trial designed to study the effectiveness of interventions that engage patient, family, and community-level resources to facilitate urban African American hypertensive patients' improved hypertension self-management and subsequent hypertension control. African American patients with uncontrolled hypertension receiving health care in an urban primary care clinic will be randomly assigned to receive 1) an educational intervention led by a community health worker alone, 2) the community health worker intervention plus a patient and family communication activation intervention, or 3) the community health worker intervention plus a problem-solving intervention. All participants enrolled in the study will receive and be trained to use a digital home blood pressure machine. The primary outcome of the randomized controlled trial will be patients' blood pressure control at 12months. Results from the ACT study will provide needed evidence on the effectiveness of comprehensive multi-level interventions to improve urban African American patients' hypertension control. Copyright © 2014 Elsevier Inc. All rights reserved.

Motivating and demotivating factors for community health workers: A qualitative study in urban slums of Delhi, India.

PubMed

George, Mathew Sunil; Pant, Shradha; Devasenapathy, Niveditha; Ghosh-Jerath, Suparna; Zodpey, Sanjay P

2017-04-01

Background Community health workers play an important role in delivering health-care services, especially to underserved populations in low- and middle-income countries. They have been shown to be successful in providing a range of preventive, promotive and curative services. This qualitative study investigated the factors motivating or demotivating community health workers in urban settings in Delhi, India. Methods In this sub-study of the ANCHUL (Ante Natal and Child Healthcare in Urban Slums) implementation research project, four focus-group discussions and nine in-depth interviews were conducted with community health workers and medical officers. Utilizing a reflexive and inductive qualitative methodology, the data set was coded, to allow categories of motivating and demotivating factors to emerge. Results Motivating factors identified were: support from family members for their work, improved self-identity, job satisfaction and a sense of social responsibility, prior experiences of ill health, the opportunity to acquire new skills and knowledge, social recognition and status conferred by the community, and flexible work and timings. Negative experiences in the community and at health centres, constraints in the local health system in response to the demand generated by the community health workers, and poor pay demotivated community health workers in this study, even causing some to quit their jobs. Conclusion Community-health-worker programmes that focus on ensuring the technical capacity of their staff may not give adequate attention to the factors that motivate or discourage these workers. As efforts get under way to ensure universal access to health care, it is important that these issues are recognized and addressed, to ensure that community health worker programmes are effective and sustainable.

A School-Based Urban Teacher Education Program That Enhances School-Community Connections

ERIC Educational Resources Information Center

Noel, Jana

2008-01-01

Urban schools today face numerous challenges. Urban poverty; high mobility in and out of neighborhoods; schools with inadequate funding to cover the educational, social, and health needs of urban children and their families; and high teacher turnover are just a few of the vital issues that call for partnerships with communities, service agencies,…

Urban Sustainability and Public Health: Throwing the Bath Water Out and Not the Baby

NASA Technical Reports Server (NTRS)

Quattrochi, Dale A.

2009-01-01

This slide presentation reviews the affect of urbanization on community health. It exams urbanization trends in the Atlanta metro area and includes information on impervious surfaces, air quality, mitigation strategies, spatial growth modeling, land use, public health surveillance and different data collection methods.

Witnessing Community Violence in Residential Neighborhoods: A Mental Health Hazard for Urban Women

PubMed Central

Ryan, Louise; Kawachi, Ichiro; Canner, Marina J.; Berkman, Lisa; Wright, Rosalind J.

2007-01-01

We examined the prevalence and psychological correlates of witnessing community violence among women of low socioeconomic status living in urban neighborhoods in the northeastern United States. Three hundred eighty-six women receiving their health care at an urban community health center were sampled to assess their violence exposures. Women were asked to report the location and timing of their exposure to witnessing violent neighborhood events in which they were not participants. The Brief Symptoms Inventory was used to assess anxiety and depressive symptoms. Controlling for marital status, educational attainment, age, and intimate partner violence victimization, women who witnessed violent acts in their neighborhoods were twice as likely to experience depressive and anxiety symptoms compared to women who did not witness community violence. Central American-born women had particularly high exposures. We conclude that witnessing neighborhood violence is a pervasive experience in this urban cohort, and is associated with anxiety and depressive symptoms, even among women who are not direct participants in violence to which they are exposed. Community violence interventions must incorporate efforts to protect the mental health of adult women who witness events in their neighborhoods. PMID:17965940

Guiding health promotion efforts with urban Inuit: a community-specific perspective on health information sources and dissemination strategies.

PubMed

McShane, Kelly E; Smylie, Janet K; Hastings, Paul D; Martin, Carmel M

2006-01-01

To develop a community-specific perspective of health information sources and dissemination strategies of urban Inuit to better guide health promotion efforts. Through a collaborative partnership with the Tungasuvvingat Inuit Family Resource Centre, a series of key informant interviews and focus groups were conducted to gather information on specific sources of health information, strategies of health information dissemination, and overall themes in health information processes. Distinct patterns of health information sources and dissemination strategies emerged from the data. Major themes included: the importance of visual learning, community Elders, and cultural interpreters; community cohesion; and the Inuit and non-Inuit distinction. The core sources of health information are family members and sources from within the Inuit community. The principal dissemination strategy for health information was direct communication, either through one-on-one interactions or in groups. This community-specific perspective of health information sources and dissemination strategies shows substantial differences from current mainstream models of health promotion and knowledge translation. Health promotion efforts need to acknowledge the distinct health information processes of this community, and should strive to integrate existing health information sources and strategies of dissemination with those of the community.

An exploration of beliefs and attitudes regarding healthy lifestyle behaviour in an urban population in The Netherlands: Results from a focus group study in a community-based prevention project.

PubMed

Kloosterboer, Sanne M; van den Brekel, Karolien; Rengers, Antonia H; Peek, Niels; de Wit, Niek J

2015-06-01

The positive effects of lifestyle intervention programmes might be enhanced when targeted to the health-related behaviour of the users. This study explores the beliefs and attitudes regarding a healthy lifestyle, the influences on lifestyle behavioural change and the needs to support a healthy lifestyle in the local community, during an integrated community-based prevention project in newly developed urban area in the Netherlands. Three focus groups were conducted with urban residents aged 45-70 (n = 28). Thematic qualitative analysis was applied to verbatim transcripts to identify emerging themes. The following themes were identified: beliefs to healthy behaviour, responsibility for health, perceived behavioural control, external influences on behavioural change and needs in the local community. Within these themes, personal responsibility for health and the influence of the social and physical environment emerged to be important for health and lifestyle. The participants expressed the need for clearly organized health and lifestyle facilities, a personalized approach and an easily accessible health risk assessment to support lifestyle behavioural change in the community. In our study, urban residents experienced a strong influence of the social and physical environment to their lifestyle behaviour. This finding supports an integrated approach for preventive health services in this population. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Community-Based Solid Waste Management: A Training Facilitator's Guide.

ERIC Educational Resources Information Center

Peace Corps, Washington, DC. Information Collection and Exchange Div.

Urban environmental management and environmental health issues are of increasing concern worldwide. The need for urban environmental management work at the local level where the Peace Corps works most effectively is significant, but training materials dedicated specifically to community-based solid waste management work in urban areas are lacking.…

Addressing Inequities in Urban Health: Do Decision-Makers Have the Data They Need? Report from the Urban Health Data Special Session at International Conference on Urban Health Dhaka 2015.

PubMed

Elsey, H; Thomson, D R; Lin, R Y; Maharjan, U; Agarwal, S; Newell, J

2016-06-01

Rapid and uncontrolled urbanisation across low and middle-income countries is leading to ever expanding numbers of urban poor, defined here as slum dwellers and the homeless. It is estimated that 828 million people are currently living in slum conditions. If governments, donors and NGOs are to respond to these growing inequities they need data that adequately represents the needs of the urban poorest as well as others across the socio-economic spectrum.We report on the findings of a special session held at the International Conference on Urban Health, Dhaka 2015. We present an overview of the need for data on urban health for planning and allocating resources to address urban inequities. Such data needs to provide information on differences between urban and rural areas nationally, between and within urban communities. We discuss the limitations of data most commonly available to national and municipality level government, donor and NGO staff. In particular we assess, with reference to the WHO's Urban HEART tool, the challenges in the design of household surveys in understanding urban health inequities.We then present two novel approaches aimed at improving the information on the health of the urban poorest. The first uses gridded population sampling techniques within the design and implementation of household surveys and the second adapts Urban HEART into a participatory approach which enables slum residents to assess indicators whilst simultaneously planning the response. We argue that if progress is to be made towards inclusive, safe, resilient and sustainable cities, as articulated in Sustainable Development Goal 11, then understanding urban health inequities is a vital pre-requisite to an effective response by governments, donors, NGOs and communities.

The impact of urbanization on the community food environment in China.

PubMed

Wu, Yang; Xue, Hong; Wang, Huijun; Su, Chang; Du, Shufa; Wang, Youfa

2017-05-01

Research on how urbanization has influenced the food environment in China is limited. The study aimed to examine the impact of urbanization on the food environment in China. Longitudinal data collected during 1989-2009 from the China Health and Nutrition Survey were used, which covered 9 provinces in China. Urbanicity index (0-10) was assessed using an urbanicity scale. Final analyses included 216 communities. Random-effect models were used in analyses. Urbanization (higher urbanicity index) increased the odds of having fast food restaurants (OR=2.78, 95% CI: 2.18-3.54) and other indoor restaurants (OR=2.93, 95% CI: 2.28-3.76) within the community, the odds of having supermarkets (OR=2.43, 95% CI: 2.04-2.89) and free markets (OR=2.56, 95% CI: 1.77-3.70) within 30 minutes' bus ride from the community. Food prices for apples (β=0.06, 95% CI: 0.04-0.08) and lean pork (β =0.02, 95% CI: 0.01-0.03) increased with urbanicity, while prices for other food did not. Urbanicity was positively associated with community norms for fast food consumption (RR=1.28, 95% CI: 1.22-1.33), fast food preferences (RR=1.09, 95% CI: 1.06-1.12) and nutrition knowledge (RR=1.02, 95% CI: 1.01-1.03). Urbanization is associated with food environment in China. The findings provide insight for future economic development and public health efforts related to urbanization.

Rural-to-Urban Migrants' Experiences with Primary Care under Different Types of Medical Institutions in Guangzhou, China

PubMed Central

Zeng, Jiazhi; Shi, Leiyu; Zou, Xia; Chen, Wen; Ling, Li

2015-01-01

Objectives China is facing the unprecedented challenge of rapidly increasing rural-to-urban migration. Migrants are in a vulnerable state when they attempt to access to primary care services. This study was designed to explore rural-to-urban migrants’ experiences in primary care, comparing their quality of primary care experiences under different types of medical institutions in Guangzhou, China. Methods The study employed a cross-sectional survey of 736 rural-to-urban migrants in Guangzhou, China in 2014. A validated Chinese version of Primary Care Assessment Tool—Adult Short Version (PCAT-AS), representing 10 primary care domains was used to collect information on migrants’ quality of primary care experiences. These domains include first contact (utilization), first contact (accessibility), ongoing care, coordination (referrals), coordination (information systems), comprehensiveness (services available), comprehensiveness (services provided), family-centeredness, community orientation and culturally competent. These measures were used to assess the quality of primary care performance as reported from patients’ perspective. Analysis of covariance was conducted for comparison on PCAT scores among migrants accessing primary care in tertiary hospitals, municipal hospitals, community health centers/community health stations, and township health centers/rural health stations. Multiple linear regression models were used to explore factors associated with PCAT total scores. Results After adjustments were made, migrants accessing primary care in tertiary hospitals (25.49) reported the highest PCAT total scores, followed by municipal hospitals (25.02), community health centers/community health stations (24.24), and township health centers/rural health stations (24.18). Tertiary hospital users reported significantly better performance in first contact (utilization), first contact (accessibility), coordination (information system), comprehensiveness (service available), and cultural competence. Community health center/community health station users reported significantly better experience in the community orientation domain. Township health center/rural health station users expressed significantly better experience in the ongoing care domain. There were no statistically significant differences across settings in the ongoing care, comprehensiveness (services provided), and family-centeredness domains. Multiple linear regression models showed that factors positively associated with higher PCAT total scores also included insurance covering parts of healthcare payment (P<0.001). Conclusions This study highlights the need for improvement in primary care provided by primary care institutions for rural-to-urban migrants. Relevant policies related to medical insurance should be implemented for providing affordable healthcare services for migrants accessing primary care. PMID:26474161

Urban tree crown health assessment system: a tool for communities and citizen foresters

Treesearch

Matthew F. Winn; Sang-Mook Lee; Philip A. Araman

2007-01-01

Trees are important assets to urban communities. In addition to the aesthetic values that urban trees provide, they also aid in such things as erosion control, pollution removal, and rainfall interception. The urban environment, however, can often produce stresses to these trees. Soil compaction, limited root growth, and groundwater contamination are just a few of the...

Service functions of private community health stations in China: A comparison analysis with government-sponsored community health stations.

PubMed

Hou, Wanli; Fan, Hong; Xu, Jing; Wang, Fang; Chai, Yun; Xu, Hancheng; Li, Yongbin; Liu, Liqun; Wang, Bin; Jin, Jianqiang; Lu, Zuxun

2012-04-01

In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available concerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based recommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.

Health Co-Benefits of Green Building Design Strategies and Community Resilience to Urban Flooding: A Systematic Review of the Evidence.

PubMed

Houghton, Adele; Castillo-Salgado, Carlos

2017-12-06

Climate change is increasingly exacerbating existing population health hazards, as well as resulting in new negative health effects. Flooding is one particularly deadly example of its amplifying and expanding effect on public health. This systematic review considered evidence linking green building strategies in the Leadership in Energy and Environmental Design ® (LEED) Rating System with the potential to reduce negative health outcomes following exposure to urban flooding events. Queries evaluated links between LEED credit requirements and risk of exposure to urban flooding, environmental determinants of health, co-benefits to public health outcomes, and co-benefits to built environment outcomes. Public health co-benefits to leveraging green building design to enhance flooding resilience included: improving the interface between humans and wildlife and reducing the risk of waterborne disease, flood-related morbidity and mortality, and psychological harm. We conclude that collaborations among the public health, climate change, civil society, and green building sectors to enhance community resilience to urban flooding could benefit population health.

Poverty and elimination of urban health disparities: challenge and opportunity.

PubMed

Thomas, Stephen B; Quinn, Sandra Crouse

2008-01-01

The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.

Building Community Disaster Resilience: Perspectives From a Large Urban County Department of Public Health

PubMed Central

Fielding, Jonathan E.; Chandra, Anita; Williams, Malcolm; Eisenman, David; Wells, Kenneth B.; Law, Grace Y.; Fogleman, Stella; Magaña, Aizita

2013-01-01

An emerging approach to public health emergency preparedness and response, community resilience encompasses individual preparedness as well as establishing a supportive social context in communities to withstand and recover from disasters. We examine why building community resilience has become a key component of national policy across multiple federal agencies and discuss the core principles embodied in community resilience theory—specifically, the focus on incorporating equity and social justice considerations in preparedness planning and response. We also examine the challenges of integrating community resilience with traditional public health practices and the importance of developing metrics for evaluation and strategic planning purposes. Using the example of the Los Angeles County Community Disaster Resilience Project, we discuss our experience and perspective from a large urban county to better understand how to implement a community resilience framework in public health practice. PMID:23678937

Gender differences in the effects of urban neighborhood on depressive symptoms in Jamaica.

PubMed

Mullings, Jasneth Asher; McCaw-Binns, Affette Michelle; Archer, Carol; Wilks, Rainford

2013-12-01

To explore the mental health effects of the urban neighborhood on men and women in Jamaica and the implications for urban planning and social development. A cross-sectional household sample of 2 848 individuals 15-74 years of age obtained from the Jamaica Health and Lifestyle Survey 2007-2008 was analyzed. Secondary analysis was undertaken by developing composite scores to describe observer recorded neighborhood features, including infrastructure, amenities/services, physical conditions, community socioeconomic status, and green spaces around the home. Depressive symptoms were assessed using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Bivariate and multivariate methods were used to explore the associations among gender, neighborhood factors, and risk of depressive symptoms. While no associations were found among rural residents, urban neighborhoods were associated with increased risk of depressive symptoms. Among males, residing in a neighborhood with poor infrastructure increased risk; among females, residing in an informal community/unplanned neighborhood increased risk. The urban neighborhood contributes to the risk of depression symptomatology in Jamaica, with different environmental stressors affecting men and women. Urban and social planners need to consider the physical environment when developing health interventions in urban settings, particularly in marginalized communities.

Characterization and Low-Cost Remediation of Soils Contaminated by Timbers in Community Gardens.

PubMed

Heiger-Bernays, W; Fraser, A; Burns, V; Diskin, K; Pierotti, D; Merchant-Borna, K; McClean, M; Brabander, D; Hynes, H P

2009-01-01

Urban community gardens worldwide provide significant health benefits to those gardening and consuming fresh produce from them. Urban gardens are most often placed in locations and on land in which soil contaminants reflect past practices and often contain elevated levels of metals and organic contaminants. Garden plot dividers made from either railroad ties or chromated copper arsenate (CCA) pressure treated lumber contribute to the soil contamination and provide a continuous source of contaminants. Elevated levels of polycyclic aromatic hydrocarbons (PAHs) derived from railroad ties and arsenic from CCA pressure treated lumber are present in the gardens studied. Using a representative garden, we 1) determined the nature and extent of urban community garden soil contaminated with PAHs and arsenic by garden timbers; 2) designed a remediation plan, based on our sampling results, with our community partner guided by public health criteria, local regulation, affordability, and replicability; 3) determined the safety and advisability of adding city compost to Boston community gardens as a soil amendment; and 4) made recommendations for community gardeners regarding healthful gardening practices. This is the first study of its kind that looks at contaminants other than lead in urban garden soil and that evaluates the effect on select soil contaminants of adding city compost to community garden soil.

Colorado Immersion Training in Community Engagement: Because You Can't Study What You Don't Know.

PubMed

Zittleman, Linda; Wright, Leslie; Ortiz, Barrientos Charlene; Fleming, Candace; Loudhawk-Hedgepeth, Crystal; Marshall, Julie; Ramirez, Lorenzo; Wheeler, Michele; Westfall, John M

2014-01-01

Community engagement (CE)has become a major element in medical research. In alliance with the goals of the Clinical and Translational Sciences Award program, Colorado Immersion Training in Community Engagement (CIT) is a community-campus partnership that aims to introduce an expanded pool of researchers to community-based participatory research (CBPR) and CE. To describe CIT components and preliminary results. CIT attempts to support a change in the research trajectory of academic health researchers, program developers, and graduate students toward CE. The program occurs on campus and in six community settings: Urban African American, urban Asian and refugee, urban Latino, urban American Indian/Alaska Native, rural northeast Colorado, and rural San Luis Valley. Components include a 4-week Directed Reading, a seminar on CBPR, 4-day community immersion, reflection, and 6-month support. Evaluation describes recruitment, implementation, and participants' understanding of CBPR and skills post-training. Fifty-eight people have participated. A comprehensive curriculum was developed to address (1) principals of CBPR, (2) health disparities, (3) listening to community, (4) self-reflection, and (5) engagement tools. Community immersions expose participants to a community's culture and opportunities to discuss health issues with a range of community members. Local "community guides" enhance participants' experience. Of the first two cohorts, 90% changed the way they plan to approach their research, 94% changed how they viewed community involvement in research, and 77% learned new skills to help engage communities in research. CIT applies to and positively impacts researchers from a variety of disciplines. CIT creates opportunities for long lasting partnerships between researchers and communities.

Urban planning and public health at CDC.

PubMed

Kochtitzky, Chris S; Frumkin, H; Rodriguez, R; Dannenberg, A L; Rayman, J; Rose, K; Gillig, R; Kanter, T

2006-12-22

Urban planning, also called city and regional planning, is a multidisciplinary field in which professionals work to improve the welfare of persons and communities by creating more convenient, equitable, healthful, efficient, and attractive places now and for the future. The centerpiece of urban planning activities is a "master plan," which can take many forms, including comprehensive plans, neighborhood plans, community action plans, regulatory and incentive strategies, economic development plans, and disaster preparedness plans. Traditionally, these plans include assessing and planning for community needs in some or all of the following areas: transportation, housing, commercial/office buildings, natural resource utilization, environmental protection, and health-care infrastructure. Urban planning and public health share common missions and perspectives. Both aim to improve human well-being, emphasize needs assessment and service delivery, manage complex social systems, focus at the population level, and rely on community-based participatory methods. Both fields focus on the needs of vulnerable populations. Throughout their development, both fields have broadened their perspectives. Initially, public health most often used a biomedical model (examining normal/abnormal functioning of the human organism), and urban planning often relied on a geographic model (analysis of human needs or interactions in a spatial context). However, both fields have expanded their tools and perspectives, in part because of the influence of the other. Urban planning and public health have been intertwined for most of their histories. In 1854, British physician John Snow used geographic mapping of an outbreak of cholera in London to identify a public water pump as the outbreak's source. Geographic analysis is a key planning tool shared by urban planning and public health. In the mid-1800s, planners such as Frederick Law Olmsted bridged the gap between the fields by advancing the concept that community design contributes to physical and mental health; serving as President Lincoln's U.S. Sanitary Commission Secretary; and designing hundreds of places, including New York's Central Park. By 1872, the disciplines were so aligned that two of the seven founders of the American Public Health Association were urban designers (an architect and a housing specialist). In 1926, the U.S. Supreme Court, in validating zoning and land-use law as a legal government authority in Village of Euclid v. Ambler Realty, cited the protection of public health as part of its justification. Other connections have included 1) pioneering urbanist Jane Jacobs, who during the 1960s, called for community design that offered safe and convenient options for walking, biking, and impromptu social interaction; and 2) the Healthy Cities movement, which began in Europe and the United States during the 1980s and now includes projects in approximately 1,000 cities that in various ways highlight the role of health as much more than the presence of medical care.

The Urban Public Hospital: Its Importance to the Black Community.

ERIC Educational Resources Information Center

Rice, Mitchell F.

1986-01-01

Describes the health care functions provided for the Black community by urban public hospitals; considers the impact of Federal retrenchment on these institutions; and examines the negative impact on Blacks, other minorities, and the poor that the sale of urban public hospitals to private, for-profit chains will have. (GC)

Health knowledge and health practices in Makeni, Sierra Leone: a community-based household survey.

PubMed

Abdelmalak, Mena J; Ahmed, Bilaal S; Mehta, Khanjan

2016-05-01

We characterize health knowledge and practices in urban and rural Makeni, Sierra Leone, drawing comparisons between areas served by community health workers (CHWs) with those that are not. We also inquire about causes of infant and maternal mortality and how they are understood in the local context. Our objective was to provide a baseline understanding of health knowledge and practices in Makeni during the implementation of a CHW program. We conducted 100 household interviews in Makeni City and rural villages in the surrounding area. We compared data between urban and rural areas to identify differences in health knowledge and practices. Our sample size covered 855 individuals. Insecticide treated bednet ownership was lower in urban settings compared to rural populations (58% vs 94%; p<.001). With regards to maternal mortality, most respondents indicated 'no clinic' (lack of clinical care or skipped antenatal care visits) as the primary cause (n=35), followed by bleeding (n=17), 'lack of blood' (anemia) (n=11) and 'will of God' (n=11). This initial survey of health knowledge and practices in rural and urban Makeni, Sierra Leone, highlights some simple opportunities for community health promotion, health education programming and behavioral interventions. Findings will inform future iterations of a CHW training module for community health education. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

PubMed

Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-03-06

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

Community Readiness for the Promotion of Physical Activity in Older Adults—A Cross-Sectional Comparison of Rural and Urban Communities

PubMed Central

Brand, Tilman; Princk, Christina; Zeeb, Hajo

2018-01-01

Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3–5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): −0.02–0.59). The rural communities showed significantly higher CR scores in the ‘Knowledge of efforts’ dimension (0.70, 95% CI: 0.26–1.14) and in the ‘Knowledge of the issue’ (0.37, 95% CI: 0.04–0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels. PMID:29509675

The Effect of an Interdisciplinary Community Health Project on Student Attitudes toward Community Health, People Who Are Indigent and Homeless, and Team Leadership Skill Development.

ERIC Educational Resources Information Center

Rose, Molly A.; Lyons, Kevin J.; Miller, Kathleen Swenson; Cornman-Levy, Diane

2003-01-01

A study of 22 health occupations students examined whether participation in an interdisciplinary community health empowerment project with urban homeless and formerly homeless people changed their attitudes about community health practice, attitudes toward people who are indigent and homeless, and perceived leadership skills. Posttests revealed a…

Prevalence of hysterectomy among rural and urban women with and without health insurance in Gujarat, India.

PubMed

Desai, Sapna; Sinha, Tara; Mahal, Ajay

2011-05-01

This paper presents findings on hysterectomy prevalence from a 2010 cross-sectional household survey of 2,214 rural and 1,641 urban, insured and uninsured women in low-income households in Ahmedabad city and district in Gujarat, India. The study investigated why hysterectomy was a leading reason for use of health insurance by women insured by SEWA, a women's organisation that operates a community-based health insurance scheme. Of insured women, 9.8% of rural women and 5.3% of urban women had had a hysterectomy, compared to 7.2% and 4.0%, respectively, of uninsured women. Approximately one-third of all hysterectomies were in women younger than 35 years of age. Rural women used the private sector more often for hysterectomy, while urban use was almost evenly split between the public and private sectors. SEWA's community health workers suggested that such young women underwent hysterectomies due to difficulties with menstruation and a range of gynaecological morbidities. The extent of these and of unnecessary hysterectomy, as well as providers' attitudes, require further investigation. We recommend the provision of information on hysterectomy as part of community health education for women, and better provision of basic gynaecological care as areas for advocacy and action by SEWA and the public health community in India. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research.

PubMed

Cochran, Gerald T; Engel, Rafael J; Hruschak, Valerie J; Tarter, Ralph E

2017-10-01

Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids. Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse. We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse. A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse. Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.

Oral Health Inequalities between Rural and Urban Populations of the African and Middle East Region.

PubMed

Ogunbodede, E O; Kida, I A; Madjapa, H S; Amedari, M; Ehizele, A; Mutave, R; Sodipo, B; Temilola, S; Okoye, L

2015-07-01

Although there have been major improvements in oral health, with remarkable advances in the prevention and management of oral diseases, globally, inequalities persist between urban and rural communities. These inequalities exist in the distribution of oral health services, accessibility, utilization, treatment outcomes, oral health knowledge and practices, health insurance coverage, oral health-related quality of life, and prevalence of oral diseases, among others. People living in rural areas are likely to be poorer, be less health literate, have more caries, have fewer teeth, have no health insurance coverage, and have less money to spend on dental care than persons living in urban areas. Rural areas are often associated with lower education levels, which in turn have been found to be related to lower levels of health literacy and poor use of health care services. These factors have an impact on oral health care, service delivery, and research. Hence, unmet dental care remains one of the most urgent health care needs in these communities. We highlight some of the conceptual issues relating to urban-rural inequalities in oral health, especially in the African and Middle East Region (AMER). Actions to reduce oral health inequalities and ameliorate rural-urban disparity are necessary both within the health sector and the wider policy environment. Recommended actions include population-specific oral health promotion programs, measures aimed at increasing access to oral health services in rural areas, integration of oral health into existing primary health care services, and support for research aimed at informing policy on the social determinants of health. Concerted efforts must be made by all stakeholders (governments, health care workforce, organizations, and communities) to reduce disparities and improve oral health outcomes in underserved populations. © International & American Associations for Dental Research 2015.

"The Road to Community Partnerships." Highlights of the Urban Maternal & Child Health Leadership Conference (Chicago, Illinois, September 14-16, 1995).

ERIC Educational Resources Information Center

Koenig, Daniel G., Ed.; Peck, Magda G., Ed.

CityMatCH is a national organization of urban maternal and child health programs and leaders. In 1995, CityMatCH sponsored a conference at which urban maternal and child health leaders from city and county health departments across the country came together for professional development and networking. This report of highlights from the conference…

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools

PubMed Central

Pardo, Gisselle; Conover, Kelly; Gopalan, Geetha; McKay, Mary

2011-01-01

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students. PMID:23564983

Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools.

PubMed

Alicea, Stacey; Pardo, Gisselle; Conover, Kelly; Gopalan, Geetha; McKay, Mary

2012-06-01

African American and Latino youth who reside in inner-city communities are at heightened risk for compromised mental health, as their neighborhoods are too often associated with serious stressors, including elevated rates of poverty, substance abuse, community violence, as well as scarce youth-supportive resources, and mental health care options. Many aspects of disadvantaged urban contexts have the potential to thwart successful youth development. Adolescents with elevated mental health needs may experience impaired judgment, poor problem-solving skills, and conflictual interpersonal relationships, resulting in unsafe sexual behavior and drug use. However, mental health services are frequently avoided by urban adolescents who could gain substantial benefit from care. Thus, the development of culturally sensitive, contextually relevant and effective services for urban, low-income African American and Latino adolescents is critical. Given the complexity of the mental health and social needs of urban youth, novel approaches to service delivery may need to consider individual (i.e., motivation to succeed in the future), family (i.e., adult support within and outside of the family), and community-level (i.e., work and school opportunities) clinical components. Step-Up, a high school-based mental health service delivery model has been developed to bolster key family, youth and school processes related to youth mental health and positive youth development. Step-Up (1) intervenes with urban minority adolescents across inner-city ecological domains; (2) addresses multiple levels (school, family and community) in order to target youth mental health difficulties; and (3) provides opportunities for increasing youth social problem-solving and life skills. Further, Step-Up integrates existing theory-driven, evidence-based interventions. This article describes Step-Up clinical goals, theoretical influences, as well as components and key features, and presents preliminary data on youth engagement for two cohorts of students.

"Weathering" HOPE VI: the importance of evaluating the population health impact of public housing demolition and displacement.

PubMed

Keene, Danya E; Geronimus, Arline T

2011-06-01

HOPE VI has funded the demolition of public housing developments across the United States and created in their place mixed-income communities that are often inaccessible to the majority of former tenants. This recent uprooting of low-income, urban, and predominantly African American communities raises concern about the health impacts of the HOPE VI program for a population that already shoulders an enormous burden of excess morbidity and mortality. In this paper, we rely on existing literature about HOPE VI relocation to evaluate the program from the perspective of weathering-a biosocial process hypothesized by Geronimus to underlie early health deterioration and excess mortality observed among African Americans. Relying on the weathering framework, we consider the effects of HOPE VI relocation on the material context of urban poverty, autonomous institutions that are health protective, and on the broader discourse surrounding urban poverty. We conclude that relocated HOPE VI residents have experienced few improvements to the living conditions and economic realities that are likely sources of stress and illness among this population. Additionally, we find that relocated residents must contend with these material realities, without the health-protective, community-based social resources that they often rely on in public housing. Finally, we conclude that by disregarding the significance of health-protective autonomous institutions and by obscuring the structural context that gave rise to racially segregated public housing projects, the discourse surrounding HOPE VI is likely to reinforce health-demoting stereotypes of low-income urban African American communities. Given the potential for urban and housing policies to negatively affect the health of an already vulnerable population, we argue that a health-equity perspective is a critical component of future policy conversations.

Community-Based Mental Health and Behavioral Programs for Low-Income Urban Youth: A Meta-Analytic Review

ERIC Educational Resources Information Center

Farahmand, Farahnaz K.; Duffy, Sophia N.; Tailor, Megha A.; Dubois, David L.; Lyon, Aaron L.; Grant, Kathryn E.; Zarlinski, Jennifer C.; Masini, Olivia; Zander, Keith J.; Nathanson, Alison M.

2012-01-01

A meta-analytic review of 33 studies and 41 independent samples was conducted of the effectiveness of community-based mental health and behavioral programs for low-income urban youth. Findings indicated positive effects, with an overall mean effect of 0.25 at post-test. While this is comparable to previous meta-analytic intervention research with…

Health needs, access to healthcare, and perceptions of ageing in an urbanizing community in India: a qualitative study.

PubMed

Bhan, Nandita; Madhira, Pavitra; Muralidharan, Arundati; Kulkarni, Bharati; Murthy, Gvs; Basu, Sanjay; Kinra, Sanjay

2017-07-19

India's elderly population is rising at an unprecedented rate, with a majority living in rural areas. Health challenges associated with ageing, changing social networks and limited public health infrastructure are issues faced by the elderly and caregivers. We examined perceptions of health needs of the elderly across local stakeholders in an urbanizing rural area. The qualitative study was conducted among participants in the Andhra Pradesh Children and Parents Study (APCAPS) site in Rangareddy district, Telangana. We collected data using focus group discussions and interviews among communities (n = 6), health providers (n = 9) and administrators (n = 6). We assessed stakeholders' views on the influence of urbanization on health issues faced and interventions for alleviating these challenges. We used a conceptual-analytical model to derive themes and used an inductive approach to organizing emerging codes as per a priori themes. These were organized as per thematic groups and ranked by different authors in order of importance. Bronfebrenner's theory was used to understand stakeholder perspectives and suggest interventions within four identified spheres of influence - individual, household, community and services. Stakeholders reported frailty, lack of transport and dependence on others as factors impacting health access of the elderly. Existing public health systems were perceived as overburdened and insensitive towards the elderly. Urbanization was viewed positively, but road accidents, crime and loneliness were significant concerns. Interventions suggested by stakeholders included health service outreach, lifestyle counseling, community monitoring of healthcare and engagement activities. We recommend integrating outreach services and lifestyle counseling within programs for care of the elderly. Community institutions can play an important role in the delivery and monitoring of health and social services for the elderly.

The urban and community health pathway: preparing socially responsive physicians through community-engaged learning.

PubMed

Meurer, Linda N; Young, Staci A; Meurer, John R; Johnson, Sheri L; Gilbert, Ileen A; Diehr, Sabina

2011-10-01

One of five options for the new required Medical College of Wisconsin Pathways program, the Urban and Community Health Pathway (UCHP), links training with community needs and assets to prepare students with the knowledge, skills, and attitudes to provide effective care in urban, underserved settings; promote community health; and reduce health disparities. Students spend at least 10 hours per month on pathway activities: 4 hours of core material delivered through readings, didactics, case discussions, and site visits; and at least 6 hours of experiential noncore activities applying core competencies, guided by an Individualized Learning Plan and faculty advisor. Noncore activities include community-engaged research, service-learning activities or other relevant experiences, and submission of a synthesis paper addressing pathway competencies. The first cohort of students began their pathways in January 2010. Of 560 participating students, 95 (of which 48 were first-year, 21 second-year, and 26 third-year students) selected UCHP. Core sessions focused on public health, social determinants, cultural humility, poverty, the local healthcare system, and safety net. During noncore time, students engaged in projects addressing homelessness, obesity, advocacy, Hmong and Latino health, HIV, asthma, and violence prevention. Students enjoyed working with peers across classes and favored interactive, community-based sessions over didactics in the classroom. Students' papers reflected a range of service and scholarly activities and a deepened appreciation of social and economic influences on health. The UCHP enriches the traditional curriculum with individualized, community-based experiences to build knowledge about health determinants and skills in partnering with communities to improve health. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Mental health, well-being, and poverty: A study in urban and rural communities in Northeastern Brazil.

PubMed

Nepomuceno, Bárbara Barbosa; Cardoso, Antonio Alan Vieira; Ximenes, Verônica Morais; Barros, João Paulo Pereira; Leite, Jáder Ferreira

2016-01-01

This article analyzes the relations between mental health and well-being in urban and rural contexts marked by poverty. The analysis takes as its basis a quantitative research conducted with 417 adult inhabitants of two communities, one rural and the other urban, in Northeastern Brazil. The data were constructed using questionnaires composed of sociodemographic data, the Personal Wellbeing Index and Self Report Questionnaire (SRQ-20) scales. We found significant differences between the inhabitants of the rural and urban communities regarding well-being and the prevalence of common mental disorders (CMD), with a higher average well-being score in the rural context; the urban sample had a higher average regarding the prevalence of CMD. The variable income significantly influenced the SRQ-20 average scores; the same was not observed with well-being scores. Besides, it was observed that there is a negative correlation with well-being and CMD.

Wilderness in the 'city' revisited: different urbes shape transmission of Echinococcus multilocularis by altering predator and prey communities.

PubMed

Liccioli, Stefano; Giraudoux, Patrick; Deplazes, Peter; Massolo, Alessandro

2015-07-01

The urbanization of Echinococcus multilocularis, the agent of alveolar echinococcosis (AE), is a public health concern worldwide. Here we propose to consider 'urban' habitats under a broad ecological perspective and discuss the effects of human settlements (urbes) on host communities and the process of parasite urbanization. We argue that interactions between landscape features (i.e., landscape composition and configuration) and host communities can shape the heterogeneity of transmission gradients observed within and across different types of human settlement. Due to unique ecological characteristics and public health management priorities, we envisage urban landscapes as a model system to further increase our understanding of host-parasite interactions shaping the circulation of E. multilocularis. Copyright © 2015 Elsevier Ltd. All rights reserved.

Social conditions and urban health inequities: realities, challenges and opportunities to transform the urban landscape through research and action.

PubMed

de Snyder, V Nelly Salgado; Friel, Sharon; Fotso, Jean Christophe; Khadr, Zeinab; Meresman, Sergio; Monge, Patricia; Patil-Deshmukh, Anita

2011-12-01

The process of urbanization entails social improvements with the consequential better quality-of-life for urban residents. However, in many low-income and some middle-income countries, urbanization conveys inequality and exclusion, creating cities and dwellings characterized by poverty, overcrowded conditions, poor housing, severe pollution, and absence of basic services such as water and sanitation. Slums in large cities often have an absence of schools, transportation, health centers, recreational facilities, and other such amenities. Additionally, the persistence of certain conditions, such as poverty, ethnic heterogeneity, and high population turnover, contributes to a lowered ability of individuals and communities to control crime, vandalism, and violence. The social vulnerability in health is not a "natural" or predefined condition but occurs because of the unequal social context that surrounds the daily life of the disadvantaged, and often, socially excluded groups. Social exclusion of individuals and groups is a major threat to development, whether to the community social cohesion and economic prosperity or to the individual self-realization through lack of recognition and acceptance, powerlessness, economic vulnerability, ill health, diminished life experiences, and limited life prospects. In contrast, social inclusion is seen to be vital to the material, psychosocial, and political aspects of empowerment that underpin social well-being and equitable health. Successful experiences of cooperation and networking between slum-based organizations, grassroots groups, local and international NGOs, and city government are important mechanisms that can be replicated in urban settings of different low- and middle-income countries. With increasing urbanization, it is imperative to design health programs for the urban poor that take full advantage of the social resources and resourcefulness of their own communities.

Urban Indian Voices: A Community-Based Participatory Research Health and Needs Assessment

ERIC Educational Resources Information Center

Johnson, Chad V.; Bartgis, Jami; Worley, Jody A.; Hellman, Chan M.; Burkhart, Russell

2010-01-01

This community-based participatory research (CBPR) project utilized a mixed-methods survey design to identify urban (Tulsa, OK) American Indian (AI) strengths and needs. Six hundred fifty AIs (550 adults and 100 youth) were surveyed regarding their attitudes and beliefs about their community. These results were used in conjunction with other…

Neighborhood characteristics and mental health among African Americans and whites living in a racially integrated urban community.

PubMed

Gary, Tiffany L; Stark, Sarah A; LaVeist, Thomas A

2007-06-01

Aspects of the environment in which one lives are increasingly being recognized as major contributors to health, yet few empirical studies have focused on mental health. Therefore, we sought to determine if neighborhood characteristics were associated with mental health outcomes among 1408 African-American (59.3%) and white (40.7%) adults living in a socio-economically homogeneous, racially integrated, urban community in Baltimore, MD. Among African Americans and whites, the perception of severe problems in the community was associated with higher levels of stress (approximately 1.8 units higher), anxiety (approximately 1.8 units higher), and depression (OR= approximately 2.0) compared to those who perceived no or few problems (all p<0.05). Community cohesion, the perception that people generally work together, was associated with better mental health among whites only. These findings give further insight into the complex environment of inner-city communities.

Cultivating resilience: urban stewardship as a means to improving health and well-being

Treesearch

Erika Svendsen

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Exploring the context in which different close-to-community sexual and reproductive health service providers operate in Bangladesh: a qualitative study.

PubMed

Mahmud, Ilias; Chowdhury, Sadia; Siddiqi, Bulbul Ashraf; Theobald, Sally; Ormel, Hermen; Biswas, Salauddin; Jahangir, Yamin Tauseef; Sarker, Malabika; Rashid, Sabina Faiz

2015-09-01

A range of formal and informal close-to-community (CTC) health service providers operate in an increasingly urbanized Bangladesh. Informal CTC health service providers play a key role in Bangladesh's pluralistic health system, yet the reasons for their popularity and their interactions with formal providers and the community are poorly understood. This paper aims to understand the factors shaping poor urban and rural women's choice of service provider for their sexual and reproductive health (SRH)-related problems and the interrelationships between these providers and communities. Building this evidence base is important, as the number and range of CTC providers continue to expand in both urban slums and rural communities in Bangladesh. This has implications for policy and future programme interventions addressing the poor women's SRH needs. Data was generated through 24 in-depth interviews with menstrual regulation clients, 12 focus group discussions with married men and women in communities and 24 semi-structured interviews with formal and informal CTC SRH service providers. Data was collected between July and September 2013 from three urban slums and one rural site in Dhaka and Sylhet, Bangladesh. Atlas.ti software was used to manage data analysis and coding, and a thematic analysis was undertaken. Poor women living in urban slums and rural areas visit a diverse range of CTC providers for SRH-related problems. Key factors influencing their choice of provider include the following: availability, accessibility, expenses and perceived quality of care, the latter being shaped by notions of trust, respect and familiarity. Informal providers are usually the first point of contact even for those clients who subsequently access SRH services from formal providers. Despite existing informal interactions between both types of providers and a shared understanding that this can be beneficial for clients, there is no effective link or partnership between these providers for referral, coordination and communication regarding SRH services. Training informal CTC providers and developing strategies to enable better links and coordination between this community-embedded cadre and the formal health sector has the potential to reduce service cost and improve availability of quality SRH (and other) care at the community level.

Health Co-Benefits of Green Building Design Strategies and Community Resilience to Urban Flooding: A Systematic Review of the Evidence

PubMed Central

Castillo-Salgado, Carlos

2017-01-01

Climate change is increasingly exacerbating existing population health hazards, as well as resulting in new negative health effects. Flooding is one particularly deadly example of its amplifying and expanding effect on public health. This systematic review considered evidence linking green building strategies in the Leadership in Energy and Environmental Design® (LEED) Rating System with the potential to reduce negative health outcomes following exposure to urban flooding events. Queries evaluated links between LEED credit requirements and risk of exposure to urban flooding, environmental determinants of health, co-benefits to public health outcomes, and co-benefits to built environment outcomes. Public health co-benefits to leveraging green building design to enhance flooding resilience included: improving the interface between humans and wildlife and reducing the risk of waterborne disease, flood-related morbidity and mortality, and psychological harm. We conclude that collaborations among the public health, climate change, civil society, and green building sectors to enhance community resilience to urban flooding could benefit population health. PMID:29210981

Child health inequities in developing countries: differences across urban and rural areas

PubMed Central

Fotso, Jean-Christophe

2006-01-01

Objectives To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. Methods The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Results Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. Conclusion The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific policies geared at preferentially improving the health and nutrition of the urban poor should be implemented, so that while targeting the best attainable average level of health, reducing gaps between population groups is also on target. To successfully monitor the gaps between urban poor and non-poor, existing data collection programs such as the DHS and other nationally representative surveys should be re-designed to capture the changing patterns of the spatial distribution of population. PMID:16831231

Child health inequities in developing countries: differences across urban and rural areas.

PubMed

Fotso, Jean-Christophe

2006-07-11

To document and compare the magnitude of inequities in child malnutrition across urban and rural areas, and to investigate the extent to which within-urban disparities in child malnutrition are accounted for by the characteristics of communities, households and individuals. The most recent data sets available from the Demographic and Health Surveys (DHS) of 15 countries in sub-Saharan Africa (SSA) are used. The selection criteria were set to ensure that the number of countries, their geographical spread across Western/Central and Eastern/Southern Africa, and their socioeconomic diversities, constitute a good yardstick for the region and allow us to draw some generalizations. A household wealth index is constructed in each country and area (urban, rural), and the odds ratio between its uppermost and lowermost category, derived from multilevel logistic models, is used as a measure of socioeconomic inequalities. Control variables include mother's and father's education, community socioeconomic status (SES) designed to represent the broad socio-economic ecology of the neighborhoods in which families live, and relevant mother- and child-level covariates. Across countries in SSA, though socioeconomic inequalities in stunting do exist in both urban and rural areas, they are significantly larger in urban areas. Intra-urban differences in child malnutrition are larger than overall urban-rural differentials in child malnutrition, and there seem to be no visible relationships between within-urban inequities in child health on the one hand, and urban population growth, urban malnutrition, or overall rural-urban differentials in malnutrition, on the other. Finally, maternal and father's education, community SES and other measurable covariates at the mother and child levels only explain a slight part of the within-urban differences in child malnutrition. The urban advantage in health masks enormous disparities between the poor and the non-poor in urban areas of SSA. Specific policies geared at preferentially improving the health and nutrition of the urban poor should be implemented, so that while targeting the best attainable average level of health, reducing gaps between population groups is also on target. To successfully monitor the gaps between urban poor and non-poor, existing data collection programs such as the DHS and other nationally representative surveys should be re-designed to capture the changing patterns of the spatial distribution of population.

Health impact caused by poor water and sanitation in district Abbottabad.

PubMed

Jabeen, Sadia; Mahmood, Qaisar; Tariq, Sumbal; Nawab, Bahadar; Elahi, Noor

2011-01-01

Large proportions of people still do not have excess to safe drinking water and proper sanitation. Qualitative and quantitative approaches were used to assess the health impacts. Random households were selected. Information was collected from questionnaire through interview schedule method, group discussion and observation checklist. People rated water and sanitation condition in urban as: 10% very good, 27% good, 20% bad, 43% very bad, and none of them said we don't know While in rural areas they rated 10% very good, 36% good, 44% bad, 6% very bad, and 4% of them said we don't know. Water sources in selected urban and rural areas were different. 37% in urban and 68% in rural area depended on bore wells as water source, 22% depended on hand pumps. In urban areas, the disease ratio was typhoid 20%, hepatitis 13%, diarrhoea 27%, skin infection 23%, stomach problems 53% and allergies 33%. In rural areas, after stomach problems, diarrhoea, hepatitis and typhoid ratio was very high as compared to urban area. In rural community, 70% were unaware of poor water and sanitation consequences on health. The water and sanitation condition in urban as well as in rural community is poor but in rural community it is even worse The drinking water was contaminated with E. coli, Enterobacter, Salmonella and Clostridium. This observation was correlated with prevalence of many water born diseases especially in rural communities of Abbottabad.

Assessing health in an urban neighborhood: community process, data results and implications for practice.

PubMed

Idali Torres, M

1998-06-01

This article examines the community process and data results of a health assessment conducted in an urban neighborhood of a middle-size city in Western Massachusetts. It describes the four-stage development process of the Health Assessment Project (HAP), a collaboration of the UMASS School of Public Health faculty and students, community based organizations and youth residents: (1) planning with a contemporary participatory approach, (2) implementing the data collection with traditional survey methodology, (3) tailoring the data analysis for a presentation at a community forum and report, and (4) incorporating the community's reaction to data results. In addition, it presents selected data results on health conditions of individual household members and perceived community health concerns and resources. Salient data results include high rates of chronic health conditions such as asthma and other respiratory problems among residents 0-18, back pain and other musculoskeletal among younger adults 19-54, and high blood pressure and other cardi-circulatory problems among older adults age 55 and older. The three most prevalent perceived community concerns are substance abuse, gangs and drug dealing. Identified community resources include sources of (1) providers of primary care, (2) health information as family/friends and Spanish media, (3) social activity such as churches and schools. Finally, this paper concludes by discussing implications for community health practice.

Generating global political priority for urban health: the role of the urban health epistemic community

PubMed Central

Shawar, Yusra Ribhi; Crane, Lani G

2017-01-01

Abstract Over the past decade there has been much discussion of the challenges posed by rapid urbanization in the developing world; yet the health of the urban poor, and especially those residing in low- and middle-income countries, continues to receive little political priority in most developing countries and at the global level. This research applies social science scholarship and a public policy analytical framework to assess the factors that have challenged efforts to make health in urban poor settings a priority. We conducted 19 semi-structured phone interviews with key urban health proponents and experts representing agencies that shape opinions and manage resources in global health. We also conducted a literature review, which included published scholarly literature and reports from organizations involved in urban health provision and advocacy. Utilizing a process-tracing method, we triangulated among these sources of data to create a historical narrative and analyse the factors that shape the global level of attention to and resources for urban health. The urban health agenda continues to be challenged by six factors, three of which concern the political context or characteristics of the issue: long-standing competition with the dominant development agenda that is rural health oriented; limited data and measurement tools that can effectively gauge the extent of the problem; and lack of evidence on how to best to address the issue. The other three factors are directly under the control of the urban health community: the community’s ineffective governance; little common understanding among its members of the problem and how to address it; and an unconvincing framing of the issue to the public. The study offers suggestions as to what advocates can do to secure greater attention and resources in order to help address the health needs of the urban poor. PMID:28582532

Conceptualizing age-friendly community characteristics in a sample of urban elders: an exploratory factor analysis.

PubMed

Smith, Richard J; Lehning, Amanda J; Dunkle, Ruth E

2013-01-01

Accurate conceptualization and measurement of age-friendly community characteristics would help to reduce barriers to documenting the effects on elders of interventions to create such communities. This article contributes to the measurement of age-friendly communities through an exploratory factor analysis of items reflecting an existing US Environmental Protection Agency policy framework. From a sample of urban elders (n = 1,376), we identified 6 factors associated with demographic and health characteristics: access to business and leisure, social interaction, access to health care, neighborhood problems, social support, and community engagement. Future research should explore the effects of these factors across contexts and populations.

Advancing Community–Based Research with Urban American Indian Populations: Multidisciplinary Perspectives

PubMed Central

Hartmann, William E.; Wendt, Dennis C.; Saftner, Melissa A.; Marcus, John; Momper, Sandra L.

2014-01-01

The U.S. has witnessed significant growth among urban AI populations in recent decades, and concerns have been raised that these populations face equal or greater degrees of disadvantage than their reservation counterparts. Surprisingly little urban AI research or community work has been documented in the literature, and even less has been written about the influences of urban settings on community-based work with these populations. Given the deep commitments of community psychology to empowering disadvantaged groups and understanding the impact of contextual factors on the lives of individuals and groups, community psychologists are well suited to fill these gaps in the literature. Toward informing such efforts, this work offers multidisciplinary insights from distinct idiographic accounts of community-based behavioral health research with urban AI populations. Accounts are offered by three researchers and one urban AI community organization staff member, and particular attention is given to issues of community heterogeneity, geography, membership, and collaboration. Each first-person account provides “lessons learned” from the urban context in which the research occurred. Together, these accounts suggest several important areas of consideration in research with urban AIs, some of which also seem relevant to reservation-based work. Finally, the potential role of research as a tool of empowerment for urban AI populations is emphasized, suggesting future research attend to the intersections of identity, sense of community, and empowerment in urban AI populations. PMID:24659391

Moving toward holistic wellness, empowerment and self-determination for Indigenous peoples in Canada: Can traditional Indigenous health care practices increase ownership over health and health care decisions?

PubMed

Auger, Monique; Howell, Teresa; Gomes, Tonya

2016-12-27

This study aimed to understand the role that traditional Indigenous health care practices can play in increasing individual-level self-determination over health care and improving health outcomes for urban Indigenous peoples in Canada. This project took place in Vancouver, British Columbia and included the creation and delivery of holistic workshops to engage community members (n = 35) in learning about aspects of traditional health care practices. Short-term and intermediate outcomes were discussed through two gatherings involving focus groups and surveys. Data were transcribed, reviewed, thematically analyzed, and presented to the working group for validation. When participants compared their experiences with traditional health care to western health care, they described barriers to care that they had experienced in accessing medical doctors (e.g., racism, mistrust), as well as the benefits of traditional healing (e.g., based on relationships, holistic approach). All participants also noted that they had increased ownership over their choices around, and access to, health care, inclusive of both western and traditional options. They stressed that increased access to traditional health care is crucial within urban settings. Self-determination within Indigenous urban communities, and on a smaller scale, ownership for individuals, is a key determinant of health for Indigenous individuals and communities; this was made clear through the analysis of the research findings and is also supported within the literature. This research also demonstrates that access to traditional healing can enhance ownership for community members. These findings emphasize that there is a continued and growing need for support to aid urban Indigenous peoples in accessing traditional health care supports.

Public Participation in Urban Environmental Management: A Model for Promoting Community-Based Environmental Management in Peri-Urban Areas.

ERIC Educational Resources Information Center

Yacoob, May; Brantly, Eugene; Whiteford, Linda

In October 1992, the Water and Sanitation for Health (WASH) Project held a workshop to explore how the U.S. Agency for International Development (USAID) could incorporate community participation as a core element in projects to improve water supply, sanitation, and other environmental conditions of peri-urban areas in developing countries. The…

[Between everyday practices and interventions: narrative fragments on environmental degradation and health in Aracaju, Brazil].

PubMed

da Fonseca, Lázaro Batista; Nobre, Maria Teresa; dos Santos, João José Gomes

2014-10-01

The scope of this paper is to describe the relationship between health production, urban growth and environmental degradation in the community of the "Urban Expansion Zone" of Aracaju in the State of Sergipe. It also touches on the impacts on the health of the population due to tourism and real estate speculation associated with the absence of basic services. Based on the assumption that illnesses caused by such changes only appear on the public health care system as a worsening of symptoms, neglecting the complex health-environment relationship, this paper highlights the possibility of pondering the bases upon which urban growth occurs in the light of imminent environmental degradation. The activities of health community agents were monitored duly connecting them to regional growth and environmental degradation. This was done from March 2010 and June 2011 adopting the ethnographic perspective as the method of choice. Other ways of inclusion in the community were mapped: contact with older residents, religious leaderships and the members of the traditional professions, etc. The results show the changes that have been occurring in the region, especially with respect to the extinction of traditional practices, increase in violence, unemployment, loss of community ties and illness.

Rural-Urban Differences in Consumer Governance at Community Health Centers

PubMed Central

Wright, David Bradley

2017-01-01

Context Community health centers (CHCs) are primary care clinics that serve mostly low-income patients in rural and urban areas. They are required to be governed by a consumer majority. What little is known about the structure and function of these boards in practice, suggests that CHC boards in rural areas may look and act differently than CHC boards in urban areas. Purpose To identify differences in the structure and function of consumer governance at CHCs in rural and urban areas. Methods Semi-structured telephone interviews were conducted with 30 CHC board members from 14 different states. Questions focused on board members’ perceptions of board composition and the role of consumers on the board. Findings CHCs in rural areas are more likely to have representative boards, are better able to convey confidence in the organization, and are better able to assess community needs than CHCs in urban areas. However, CHCs in rural areas often have problems achieving objective decision-making, and may have fewer means for objectively evaluating quality of care due to the lack of patient board member anonymity. Conclusions Consumer governance is implemented differently in rural and urban communities, and the advantages and disadvantages in each setting are unique. PMID:23551642

Environmental and community health: a reciprocal relationship

Treesearch

Jeffery Sugarman

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Urban gardens: catalysts for restorative commons infrastructure

Treesearch

John Seitz

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Health Impacts of Increased Physical Activity from Changes in Transportation Infrastructure: Quantitative Estimates for Three Communities

PubMed Central

2015-01-01

Recently, two quantitative tools have emerged for predicting the health impacts of projects that change population physical activity: the Health Economic Assessment Tool (HEAT) and Dynamic Modeling for Health Impact Assessment (DYNAMO-HIA). HEAT has been used to support health impact assessments of transportation infrastructure projects, but DYNAMO-HIA has not been previously employed for this purpose nor have the two tools been compared. To demonstrate the use of DYNAMO-HIA for supporting health impact assessments of transportation infrastructure projects, we employed the model in three communities (urban, suburban, and rural) in North Carolina. We also compared DYNAMO-HIA and HEAT predictions in the urban community. Using DYNAMO-HIA, we estimated benefit-cost ratios of 20.2 (95% C.I.: 8.7–30.6), 0.6 (0.3–0.9), and 4.7 (2.1–7.1) for the urban, suburban, and rural projects, respectively. For a 40-year time period, the HEAT predictions of deaths avoided by the urban infrastructure project were three times as high as DYNAMO-HIA's predictions due to HEAT's inability to account for changing population health characteristics over time. Quantitative health impact assessment coupled with economic valuation is a powerful tool for integrating health considerations into transportation decision-making. However, to avoid overestimating benefits, such quantitative HIAs should use dynamic, rather than static, approaches. PMID:26504832

Health Impacts of Increased Physical Activity from Changes in Transportation Infrastructure: Quantitative Estimates for Three Communities.

PubMed

Mansfield, Theodore J; MacDonald Gibson, Jacqueline

2015-01-01

Recently, two quantitative tools have emerged for predicting the health impacts of projects that change population physical activity: the Health Economic Assessment Tool (HEAT) and Dynamic Modeling for Health Impact Assessment (DYNAMO-HIA). HEAT has been used to support health impact assessments of transportation infrastructure projects, but DYNAMO-HIA has not been previously employed for this purpose nor have the two tools been compared. To demonstrate the use of DYNAMO-HIA for supporting health impact assessments of transportation infrastructure projects, we employed the model in three communities (urban, suburban, and rural) in North Carolina. We also compared DYNAMO-HIA and HEAT predictions in the urban community. Using DYNAMO-HIA, we estimated benefit-cost ratios of 20.2 (95% C.I.: 8.7-30.6), 0.6 (0.3-0.9), and 4.7 (2.1-7.1) for the urban, suburban, and rural projects, respectively. For a 40-year time period, the HEAT predictions of deaths avoided by the urban infrastructure project were three times as high as DYNAMO-HIA's predictions due to HEAT's inability to account for changing population health characteristics over time. Quantitative health impact assessment coupled with economic valuation is a powerful tool for integrating health considerations into transportation decision-making. However, to avoid overestimating benefits, such quantitative HIAs should use dynamic, rather than static, approaches.

Fine-Scale Environmental Indicators of Public Health and Well-Being for Urban Communities

EPA Science Inventory

Urban ecosystem services contribute to public health and well-being by buffering natural and man-made hazards, and by promoting healthful lifestyles that include physical activity, social interaction, and engagement with nature. As part of the EnviroAtlas online mapping tool, EP...

Perceptions of health, health care and community-oriented health interventions in poor urban communities of Kinshasa, Democratic Republic of Congo.

PubMed

Maketa, Vivi; Vuna, Mimy; Baloji, Sylvain; Lubanza, Symphorien; Hendrickx, David; Inocêncio da Luz, Raquel Andrea; Boelaert, Marleen; Lutumba, Pascal

2013-01-01

In Democratic Republic of Congo access to health care is limited because of many geographical and financial barriers, while quality of care is often low. Global health donors assist the country with a number of community-oriented interventions such as free distribution of bednets, antihelminthic drugs, vitamin A supplementation and vaccination campaigns, but uptake of these interventions is not always optimal. The aim of this study was to explore the perceptions of poor urban communities of the capital Kinshasa with regard to health issues in general as well as their experiences and expectations concerning facility-based health services and community-oriented health interventions. Applying an approach rooted in the grounded theory framework, focus group discussions were conducted in eight neighborhoods of poor urban areas in the city of Kinshasa in July 2011. Study participants were easily able to evoke the city's major health problems, with the notable exceptions of malnutrition and HIV/AIDS. They perceive the high out-of-pocket cost of health services as the major obstacle when seeking access to quality care. Knowledge of ongoing community-oriented health interventions seems good. Still, while the study participants agree that those interventions are beneficial; their acceptability seems to be problematic. This is chiefly put down to a lack of information and government communication about the programs and their interventions. Furthermore, the study participants referred to rumors and the deterring effect of stories about alleged harmful consequences of those interventions. Along with improving the provision and quality of general health care, the government and international actors must improve their efforts in informing the communities about disease control programs, their rationale and benefit/risk ratio. Directly engaging community members in a dialogue might be beneficial in terms of improving acceptability and overall access to health services and interventions. Novel ways of reducing the high out-of-pocket expenditure should also be explored.

Urban Indians: Hope and Hopelessness.

ERIC Educational Resources Information Center

Fogarty, Mark

1999-01-01

Describes problems faced by Americans Indians and Alaska Natives in U.S. urban centers with large Native populations. Describes social services, health and employment services, job training, and cultural events provided by nonprofit community groups to Native communities in Anchorage, Los Angeles, and New York City. (CDS)

Assessing Health Disparities in Rural Hawaii Using the Hoshin Facilitation Method

ERIC Educational Resources Information Center

Withy, Kelley; Andaya, January May; Mikami, Judith S.; Yamada, Seiji

2007-01-01

Context: Health disparities between rural and urban communities are well documented. There are many suggested causes and many proposed solutions but no one-size-fits-all answer. The most successful community interventions have been introduced by communities themselves. However, before communities invest in such interventions, each group must…

The Quality of Urban Environments: Mapping Variation in Access to Community Resources.

ERIC Educational Resources Information Center

Witten, Karen; Exeter, Daniel; Field, Adrian

2003-01-01

Discusses the relationship between community infrastructure and health through the development of the Community Resource Accessibility Index (CRAI) research tool.This area-based index of community services, facilities, and amenities enables comparisons between opportunity structures in the local environment and residents' health and wellbeing. It…

24 CFR 582.5 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

...). The term nonprofit organization also includes a community mental health center established as a public... appropriate services, including health care, mental health treatment, alcohol and other substance abuse... ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT...

Marketplace Clinics Complementing Diabetes Care for Urban Residing American Indians

PubMed Central

Rick, Robert; Hoye, Robert E.; Thron, Raymond W.; Kumar, Vibha

2017-01-01

Introduction: For several decades, the Minneapolis American Indian population has experienced limited health care access and threefold diabetes health disparity. As part of an urban health initiative, the marketplace clinics located in nearby CVS, Target, and Supervalu stores committed financial support, providers, certified educators, and pharmacy staff for a community-based diabetes support group. Objectives: To measure the extent to which collaborating marketplace clinics and the community-based support group expanded diabetes care and provided self-management education for this largely urban Indian neighborhood. Methods: A controlled quasi-experimental study and 3-years retrospective analysis of secondary data were used to test whether the Minneapolis marketplace clinics and the community diabetes support group participants (n = 48) had improved diabetes health outcomes relative to the comparison group (n = 87). The marketplace complemented intervention group employed motivational interviewing and the patient activation measure (PAM®) in coaching diabetes self-care and behavioral modification. The federally funded comparison group received only basic self-management education. Results: T tests and effect sizes were used to quantify the difference between the study intervention and comparison groups. Statistical significance was determined for the following outcome variables: A1C (P < .01), body mass index (P < .04), and PAM® (P < .001). Discussion: Includes strengths, limitations, and future study recommendations. Conclusions: Positive effects of marketplace clinics and community health complementation were found with regard to improved blood glucose control, weight loss, and healthful lifestyle adaptation. Primary care and community health improvements could be realized by incorporating patient activation with diabetes prevention programs for the urban Indian two-thirds majority of the United States 5 million American Indian population. PMID:28707507

The Variables Associated With Health Promotion Behaviors Among Urban Black Women.

PubMed

Hepburn, Millie

2018-04-24

To improve understanding of variables impacting health promotion behaviors among urban Black women. A cross-sectional survey was used. Urban Black women (N = 132) between the ages of 30 to 64 years participated. The study was conducted in a U.S. metropolitan region in 2015. Health literacy (Newest Vital Sign [NVS]), self-efficacy (New General Self-Efficacy Scale [NGSE]), and readiness for change (Health Risk Instrument [HRI]) were correlated with health promotion behaviors (Health Promotion Lifestyle Profile II [HPLPII]). Univariate statistics addressed demographic characteristics; bivariate/simultaneous linear regression determined the relationships between the NVS, NGSE, and HRI to health promotion behaviors (HPLPII). Demographics: 72.6% completed high school and 25% completed college, and the mean body mass index (BMI) was >32. Positive correlations existed between each variable to health promotion behaviors: NVS (r = .244, p < .002), NGSE (r = .312, p < .001), HRI (r = .440, p < .001), and accounted for 29.8% of variances in health promotion behaviors. Education and health literacy were also correlated (r s = .414, p = .001). Although health literacy, self-efficacy, and readiness for change are associated with health promotion behaviors, readiness for change was the most highly correlated. The development and incorporation of interventions to promote health promotion behaviors should include readiness for change, health literacy, BMI, and education, especially among urban Black women in order to reduce critical health disparities. Community-based and culturally relevant strategies in promoting health that are integrated into existing lifestyles and designed to impact readiness for change will have the greatest impact on reducing health disparities both in the United States and in countries experiencing rapid urbanization. For example, healthy eating behaviors or increased physical activity may be best adopted when integrated into existing community-based spiritual or cultural events via trusted community leaders. Replication of this study in other populations of Black women will improve the generalizability of this study, both in the United States and globally. However, the addition of other demographic variables, such as a history of chronic conditions, military service, domestic or other violence, spirituality, and the availability of community resources, would strengthen the results in future studies. © 2018 Sigma Theta Tau International.

The benefits of community-managed open space: community gardening in New York City

Treesearch

Edie Stone

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Social support and depressive symptom disparity between urban and rural older adults in China.

PubMed

Hu, Hongwei; Cao, Qi; Shi, Zhenzhen; Lin, Weixia; Jiang, Haixia; Hou, Yucheng

2018-09-01

Depressive symptom disparity between urban and rural older adults is an important public health issue in China. Social support is considered as an effective way to alleviate depression of older adults. This study aimed to investigate the extent to which social support could explain the depressive symptom disparity between urban and rural older adults in China. This study used data drawn from the 2011 China Health and Retirement Longitudinal Study with 6,772 observations. Multiple data analysis strategies were adopted, including descriptive analyses, bivariate analyses, regression analyses and decomposition analyses. There were significant depressive symptom disparities between urban and rural older adults in China. Social support had significant association with depressive symptom of older adults while adjusting for covariates. About 25%-28% of the depressive symptom disparities could be attributed to urban-rural gaps in social support, in which community support contributed 21%-25%. Educational level and physical health status also contributed to the disparities. This study only established correlations between social support and depressive symptom disparity rather than casual relationships; and the self-reported measurement of depressive symptom and the unobservable cultural factors might cause limitations. The urban-rural gap in social support, especially community support was a prime explanation for depressive symptom disparities between urban and rural older adults in China. To reduce the depressive symptom disparities, effective community construction in rural China should be put into place, including improving the infrastructure construction, strengthening the role of social organizations, and encouraging community interpersonal interactions for older adults. Copyright © 2018 Elsevier B.V. All rights reserved.

Path to health asthma study: A survey of pediatric asthma in an urban community.

PubMed

Alicea-Alvarez, Norma; Foppiano Palacios, Carlo; Ortiz, Melanie; Huang, Diana; Reeves, Kathleen

2017-04-01

Minority children with asthma who live in low-income urban communities bear a disproportionate burden of the disease. This study explores the perceived health care needs related to asthma care, identifies asthma triggers, potential barriers to care, and assesses the need for additional community resources. We conducted a cross-sectional survey of Hispanic and African American adults (n = 53) who take care of a child with asthma and live in an urban community of North Philadelphia. Input from community leaders was obtained in the development the survey tool resulting in a unique 'community-centric' questionnaire. The survey was also available in Spanish. All surveys were conducted in the community setting. Variables were used to measure asthma severity and triggers. Children were categorized with intermittent (n = 24, 45.3%), mild persistent (n = 13, 24.5%), or moderate-to-severe persistent asthma (n = 16, 30.2%). Most children with persistent asthma were enrolled under Medicaid or CHIP (n = 24, p = 0.011) and reflected a low-income socioeconomic status. Persistent asthma was found to be associated with most triggers: pets, dust mites, mice, mold, and cockroaches. There was no significant association between environmental tobacco smoke and persistent asthma. Children with persistent asthma and 2 or more triggers were more likely to be hospitalized and go to the Emergency Department. Urban minority children living in low-income communities face neighborhood-specific asthma triggers and challenges to care. Studies conducted in urban neighborhoods, with collaboration from community members, will highlight the need of comprehensive services to account for community-centric social determinants.

Conceptualizing Age-Friendly Community Characteristics in a Sample of Urban Elders: An Exploratory Factor Analysis

PubMed Central

Smith, Richard J.; Lehning, Amanda J.; Dunkle, Ruth E.

2012-01-01

Accurate conceptualization and measurement of age-friendly community characteristics would help to reduce barriers to documenting the effects on elders of interventions to create such communities. This article contributes to the measurement of age-friendly communities through an exploratory factor analysis of items reflecting an existing U.S. Environmental Protection Agency policy framework. From a sample of urban elders (n =1,376), we identified six factors associated with demographic and health characteristics: Access to Business and Leisure, Social Interaction, Access to Health Care, Neighborhood Problems, Social Support, and Community Engagement. Future research should explore the effects of these factors across contexts and populations. PMID:23350565

Cultural Capital and Self-Rated Health in Low Income Women: Evidence from the Urban Health Study, Beirut, Lebanon

PubMed Central

Mowafi, Mona

2006-01-01

This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using χ2 tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95–6.95) and 2.9 (CI: 2.09–4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities. PMID:16739047

Cultural capital and self-rated health in low income women: evidence from the Urban Health Study, Beirut, Lebanon.

PubMed

Khawaja, Marwan; Mowafi, Mona

2006-05-01

This paper examines the association between cultural capital and self-rated psychosocial health among poor, ever-married Lebanese women living in an urban context. Both self-rated general and mental health status were assessed using data from a cross-sectional survey of 1,869 women conducted in 2003. Associations between self-rated general and mental health status and cultural capital were obtained using chi (2) tests and odds ratios from binary logistic regression models. Cultural capital had significant associations with self-perceived general and mental health status net of the effects of social capital, SES, demographics, community and health risk factors. For example, the odds ratios for poor general and mental health associated with low cultural capital were 4.5 (CI: 2.95-6.95) and 2.9 (CI: 2.09-4.05), respectively, as compared to participants with high cultural capital. As expected, health risk factors were significantly associated with both measures of health status. However, demographic and community variables were associated with general health but not with mental health status. The findings pertaining to social capital and measures of SES were mixed. Cultural capital was a powerful and significant predictor of self-perceived general and mental health among women living in poor urban communities.

CONTRIBUTION OF HOUSEHOLD ACTIVITIES TO THE HEALTH OF URBAN ECOSYSTEMS

EPA Science Inventory

With a majority of humans now living in urban and suburban areas, innovative methods are needed for land use planning to maintain healthy urban communities and ecosystems. As urban areas expand, an increasing number of human-environmental interactions take place, particularly al...

Inappropriate Use of Antibiotics and Its Associated Factors among Urban and Rural Communities of Bahir Dar City Administration, Northwest Ethiopia

PubMed Central

Gebeyehu, Endalew; Bantie, Laychiluh; Azage, Muluken

2015-01-01

Background Inappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration. Methods A comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics. Results Inappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals. Conclusions Inappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics. PMID:26379031

Inappropriate Use of Antibiotics and Its Associated Factors among Urban and Rural Communities of Bahir Dar City Administration, Northwest Ethiopia.

PubMed

Gebeyehu, Endalew; Bantie, Laychiluh; Azage, Muluken

2015-01-01

Inappropriate use of antibiotics in the community plays a role in the emergence and spread of bacteria resistant to antibiotics which threatens human health significantly. The present study was designed to determine inappropriate use of antibiotics and its associated factors among urban and rural communities of Bahir Dar city administration. A comparative cross sectional study design was conducted in urban and rural kebeles of Bahir Dar city administration from February 1 to March 28, 2014. A total of 1082 participants included in the study using a systematic random sampling technique. Data was collected using pre-tested and structured questionnaire. Data was coded and entered into SPSSS version 16 for statistical analysis. Bivariate and multivariate logistic regression model were used to identify factors associated with inappropriate use of antibiotics. Inappropriate use of antibiotics was 30.9% without significant difference between urban (33.1%) and rural (29.2%) communities. From the inappropriate antibiotic use practice, self-medication was 18.0% and the remaining (12.9%) was for family member medication. Respiratory tract symptoms (74.6%), diarrhea (74.4%), and physical injury/wound (64.3%) were the three main reasons that the communities had used antibiotics inappropriately. Factors associated with inappropriate use of antibiotics were low educational status, younger age, unsatisfaction with the health care services, engagement with a job, and low knowledge on the use of antibiotic preparations of human to animals. Inappropriate use of antibiotic exists in the study area with no significant difference between urban and rural communities. The study indicated an insight on what factors that intervention should be made to reduce inappropriate use of antibiotics in the community. Interventions that consider age groups, educational status, common health problems and their jobs together with improvement of health care services should be areas of focus to reduce inappropriate use of antibiotics.

Not just a walk in the park: efficacy to effectiveness for after school programs in communities of concentrated urban poverty.

PubMed

Frazier, Stacy L; Mehta, Tara G; Atkins, Marc S; Hur, Kwan; Rusch, Dana

2013-09-01

This study examined a model for mental health consultation, training and support designed to enhance the benefits of publicly-funded recreational after-school programs in communities of concentrated urban poverty for children's academic, social, and behavioral functioning. We assessed children's mental health needs and examined the feasibility and impact of intervention on program quality and children's psychosocial outcomes in three after-school sites (n = 15 staff, 89 children), compared to three demographically-matched sites that received no intervention (n = 12 staff, 38 children). Findings revealed high staff satisfaction and feasibility of intervention, and modest improvements in observed program quality and staff-reported children's outcomes. Data are considered with a public health lens of mental health promotion for children in urban poverty.

Community-Oriented Primary Care in Action: A Dallas Story

PubMed Central

Pickens, Sue; Boumbulian, Paul; Anderson, Ron J.; Ross, Samuel; Phillips, Sharon

2002-01-01

Dallas County, Texas, is the site of the largest urban application of the community-oriented primary care (COPC) model in the United States. We summarize the development and implementation of Dallas’s Parkland Health & Hospital System COPC program. The complexities of implementing and managing this comprehensive community-based program are delineated in terms of Dallas County’s political environment and the components of COPC (assessment, prioritization, community collaboration, health care system, evaluation, and financing). Steps to be taken to ensure the future growth and development of the Dallas program are also considered. The COPC model, as implemented by Parkland, is replicable in other urban areas. PMID:12406794

Community and family perspectives on addressing overweight in urban, African-American youth.

PubMed

Burnet, Deborah L; Plaut, Andrea J; Ossowski, Kathryn; Ahmad, Afshan; Quinn, Michael T; Radovick, Sally; Gorawara-Bhat, Rita; Chin, Marshall H

2008-02-01

To assess weight-related beliefs and concerns of overweight urban, African-American children, their parents, and community leaders before developing a family-based intervention to reduce childhood overweight and diabetes risk. We conducted 13 focus groups with overweight children and their parents and eight semistructured interviews with community leaders. Focus group participants (N = 67) from Chicago's South Side were recruited through flyers in community sites. Interview participants (N = 9) were recruited to sample perspectives from health, fitness, education, civics, and faith leaders. Community leaders felt awareness was higher for acute health conditions than for obesity. Parents were concerned about their children's health, but felt stressed by competing priorities and constrained by lack of knowledge, parenting skills, time, and financial resources. Parents defined overweight in functional terms, whereas children relied upon physical appearances. Children perceived negative social consequences of overweight. Parents and children expressed interest in family-based interventions to improve nutrition and physical activity and offered suggestions for making programs interesting. This study provides insights into the perspectives of urban, African-American overweight children, their parents, and community leaders regarding nutrition and physical activity. The specific beliefs of these respondents can become potential leverage points in interventions.

Australian rural, remote and urban community nurses' health promotion role and function.

PubMed

Roden, Janet; Jarvis, Lynda; Campbell-Crofts, Sandra; Whitehead, Dean

2016-09-01

Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Eliciting health care priorities in developing countries: experimental evidence from Guatemala.

PubMed

Font, Joan Costa; Forns, Joan Rovira; Sato, Azusa

2016-02-01

Although some methods for eliciting preferences to assist participatory priority setting in health care in developed countries are available, the same is not true for poor communities in developing countries whose preferences are neglected in health policy making. Existing methods grounded on self-interested, monetary valuations that may be inappropriate for developing country settings where community care is provided through 'social allocation' mechanisms. This paper proposes and examines an alternative methodology for eliciting preferences for health care programmes specifically catered for rural and less literate populations but which is still applicable in urban communities. Specifically, the method simulates a realistic collective budget allocation experiment, to be implemented in both rural and urban communities in Guatemala. We report evidence revealing that participatory budget-like experiments are incentive compatible mechanisms suitable for revealing collective preferences, while simultaneously having the advantage of involving communities in health care reform processes. © The Author 2015. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Effects of urban development on stream ecosystems in nine metropolitan study areas across the United States

USGS Publications Warehouse

Coles, James F.; McMahon, Gerard; Bell, Amanda H.; Brown, Larry R.; Fitzpatrick, Faith A.; Scudder Eikenberry, Barbara C.; Woodside, Michael D.; Cuffney, Thomas F.; Bryant, Wade L.; Cappiella, Karen; Fraley-McNeal, Lisa; Stack, William P.

2012-01-01

Which urban-related stressors are most closely linked to biological community degradation, and how can multiple stressors be managed to protect stream health as a watershed becomes increasingly urbanized?

Identification of priority health conditions for field-based screening in urban slums in Bangalore, India.

PubMed

Abdi, Sarah; Wadugodapitiya, Avanti; Bedaf, Sandra; George, Carolin Elizabeth; Norman, Gift; Hawley, Mark; de Witte, Luc

2018-03-02

Urban slums are characterised by unique challenging living conditions, which increase their inhabitants' vulnerability to specific health conditions. The identification and prioritization of the key health issues occurring in these settings is essential for the development of programmes that aim to enhance the health of local slum communities effectively. As such, the present study sought to identify and prioritise the key health issues occurring in urban slums, with a focus on the perceptions of health professionals and community workers, in the rapidly growing city of Bangalore, India. The study followed a two-phased mixed methods design. During Phase I of the study, a total of 60 health conditions belonging to four major categories: - 1) non-communicable diseases; 2) infectious diseases; 3) maternal and women's reproductive health; and 4) child health - were identified through a systematic literature review and semi-structured interviews conducted with health professionals and other relevant stakeholders with experience working with urban slum communities in Bangalore. In Phase II, the health issues were prioritised based on four criteria through a consensus workshop conducted in Bangalore. The top health issues prioritized during the workshop were: diabetes and hypertension (non-communicable diseases category), dengue fever (infectious diseases category), malnutrition and anaemia (child health, and maternal and women's reproductive health categories). Diarrhoea was also selected as a top priority in children. These health issues were in line with national and international reports that listed them as top causes of mortality and major contributors to the burden of diseases in India. The results of this study will be used to inform the development of technologies and the design of interventions to improve the health outcomes of local communities. Identification of priority health issues in the slums of other regions of India, and in other low and lower middle-income countries, is recommended.

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand

PubMed Central

Kittayapong, Pattamaporn; Thongyuan, Suporn; Olanratmanee, Phanthip; Aumchareoun, Worawit; Koyadun, Surachart; Kittayapong, Rungrith; Butraporn, Piyarat

2012-01-01

Background Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. Methodology Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. Results Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. Conclusion An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities. PMID:23318236

Application of eco-friendly tools and eco-bio-social strategies to control dengue vectors in urban and peri-urban settings in Thailand.

PubMed

Kittayapong, Pattamaporn; Thongyuan, Suporn; Olanratmanee, Phanthip; Aumchareoun, Worawit; Koyadun, Surachart; Kittayapong, Rungrith; Butraporn, Piyarat

2012-12-01

Dengue is considered one of the most important vector-borne diseases in Thailand. Its incidence is increasing despite routine implementation of national dengue control programmes. This study, conducted during 2010, aimed to demonstrate an application of integrated, community-based, eco-bio-social strategies in combination with locally-produced eco-friendly vector control tools in the dengue control programme, emphasizing urban and peri-urban settings in eastern Thailand. Three different community settings were selected and were randomly assigned to intervention and control clusters. Key community leaders and relevant governmental authorities were approached to participate in this intervention programme. Ecohealth volunteers were identified and trained in each study community. They were selected among active community health volunteers and were trained by public health experts to conduct vector control activities in their own communities using environmental management in combination with eco-friendly vector control tools. These trained ecohealth volunteers carried out outreach health education and vector control during household visits. Management of public spaces and public properties, especially solid waste management, was efficiently carried out by local municipalities. Significant reduction in the pupae per person index in the intervention clusters when compared to the control ones was used as a proxy to determine the impact of this programme. Our community-based dengue vector control programme demonstrated a significant reduction in the pupae per person index during entomological surveys which were conducted at two-month intervals from May 2010 for the total of six months in the intervention and control clusters. The programme also raised awareness in applying eco-friendly vector control approaches and increased intersectoral and household participation in dengue control activities. An eco-friendly dengue vector control programme was successfully implemented in urban and peri-urban settings in Thailand, through intersectoral collaboration and practical action at household level, with a significant reduction in vector densities.

Correlates of Externalizing Behavior Symptoms among Youth within Two Impoverished, Urban Communities

ERIC Educational Resources Information Center

Gopalan, Geetha; Cavaleri, Mary A.; Bannon, William M.; McKay, Mary M.

2009-01-01

This study examines whether risk factors associated with child externalizing behavior symptoms differ between two similar low-income, urban communities, using baseline parent data of 154 African American youth (ages 9-15) participating in the Collaborative HIV-Prevention and Adolescent Mental Health Project (CHAMP) family program. Separate…

Position of social determinants of health in urban man-made lakes plans.

PubMed

Shojaei, Parisa; Karimloo, Masoud; Mohammadi, Farahnaz; Malek Afzali, Hossein; Forouzan, Ameneh Setareh

2013-09-04

A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Participants' points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community's health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration.

Restorative Commons: Creating Health and Well-Being Through Urban Landscapes

Treesearch

Lindsay Campbell; Anne Wiesen

2009-01-01

A collection of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban environment. This volume is a joint endeavor of Meristem and the U.S. Forest Service...

Perceptions of health stakeholders on task shifting and motivation of community health workers in different socio demographic contexts in Kenya (nomadic, peri-urban and rural agrarian)

PubMed Central

2014-01-01

Background The shortage of health professionals in low income countries is recognized as a crisis. Community health workers are part of a “task-shift” strategy to address this crisis. Task shifting in this paper refers to the delegation of tasks from health professionals to lay, trained volunteers. In Kenya, there is a debate as to whether these volunteers should be compensated, and what motivation strategies would be effective in different socio-demographic contexts, based type of tasks shifted. The purpose of this study was to find out, from stakeholders’ perspectives, the type of tasks to be shifted to community health workers and the appropriate strategies to motivate and retain them. Methods This was an analytical comparative study employing qualitative methods: key informant interviews with health policy makers, managers, and service providers, and focus group discussions with community health workers and service consumers, to explore their perspectives on tasks to be shifted and appropriate motivation strategies. Results The study found that there were tasks to be shifted and motivation strategies that were common to all three contexts. Common tasks were promotive, preventive, and simple curative services. Common motivation strategies were supportive supervision, means of identification, equitable allocation of resources, training, compensation, recognition, and evidence based community dialogue. Further, in the nomadic and peri-urban sites, community health workers had assumed curative services beyond the range provided for in the Kenyan task shifting policy. This was explained to be influenced by lack of access to care due to distance to health facilities, population movement, and scarcity of health providers in the nomadic setting and the harsh economic realities in peri-urban set up. Therefore, their motivation strategies included training on curative skills, technical support, and resources for curative care. Data collection was viewed as an important task in the rural site, but was not recognized as priority in nomadic and peri-urban sites, where they sought monetary compensation for data collection. Conclusions The study concluded that inclusion of curative tasks for community health workers, particularly in nomadic contexts, is inevitable but raises the need for accreditation of their training and regulation of their tasks. PMID:25079588

Canadian Residential Schools and Urban Indigenous Knowledge Production about Diabetes

PubMed Central

Howard, Heather A.

2016-01-01

The construction of illness as an inscription on the body of colonization figures importantly among Indigenous community-based service and health care providers. While residential schools and diabetes have both been characterized as products of colonization, little work has been done to examine how they are connected to and informative for health provider practice. The research data presented in this article come from a collaborative urban Indigenous community-based study examining the legacy of negative relationships with food that was instilled in residential schools and used in diabetes intervention. I illustrate how residential school disciplined eating, providing a context for understanding the contemporary production of Indigenous health knowledge and practice in the urban setting, and the diet-related management of diabetes. PMID:24964719

Climate change and health vulnerability in informal urban settlements in the Ethiopian Rift Valley

NASA Astrophysics Data System (ADS)

Bambrick, Hilary; Moncada, Stefano; Briguglio, Marie

2015-05-01

Climate change in Ethiopia is occurring against a backdrop of rapid population growth and urbanization, entrenched poverty and a heavy burden of disease, and there is little information on specific health risks with which to approach adaptation planning and strengthen adaptive capacity. Using detailed household surveys (400 households, 1660 individuals, 100% participation) and focus groups in two informal urban communities in the Southern city of Shashemene, we identified locally relevant hazards and found that climate change is likely to intensify existing problems associated with poverty. We also showed that despite their proximity (situated only 1 km apart) the two communities differ in key characteristics that may affect climate change vulnerability and require nuanced approaches to adaptation. Detailed, community-level research is therefore necessary, especially where other sources of data are lacking, to ensure that adaptation activities in the world’s poorest communities address relevant risks.

Effect of residence on mothers' health care seeking behavior for common childhood illness in Northwest Ethiopia: a community based comparative cross--sectional study.

PubMed

Gelaw, Yalemzewod Assefa; Biks, Gashaw Andargie; Alene, Kefyalew Addis

2014-10-08

Children are at higher risk of acquiring infections and developing severe disease. This study assessed the health care seeking behavior and associated factors of urban and rural mothers for common childhood illness in Northwest Ethiopia. A comparative community based cross-sectional study was conducted among urban and rural mothers living in the district. A multistage sampling technique was used to select the study participants. A pre-tested and structured questioner via interview was used to collect the data. Binary logistic regression analysis was used to identify associated factors. Odds ratio with 95% CI was computed to assess the strength of the associations. A total of 827 (274 urban and 553 rural) mothers were interviewed. Among these, 79.3% (95% CI: (76.5%, 82.06%)) of the mothers were sought health care in the district. Health care seeking behavior was higher among urban mothers (84.6%) than rural mothers (76.7%). Marital status, completion health extension package, and sex of child were significantly associated with health care seeking behavior of urban mothers. Whereas age of child, age and occupation of mothers, educational level of fathers, wealth quintile, and type of reported illness were significantly associated with rural mothers. Perceived severity of illness was significantly associated with both urban and rural mothers for health care seeking behavior. The overall health seeking behaviors of mothers for common childhood illness was high. However, urban mothers seek health care more than rural. Socio Economic position and types of reported illness has an effect for health seeking behavior of rural mothers. Whereas child sex preference and graduation status for health extension package has an effect for health care seeking behavior of urban mothers. Work on strengthen accessibility of health care services in the rural mothers and increase awareness of mothers about the disadvantage of sex preferences will improve the health care seek behavior of families regardless of the severity of illness and types of illnesses.

Evaluation of the acceptability of a CD-Rom as a health promotion tool for Inuit in Ottawa.

PubMed

McShane, Kelly E; Smylie, Janet K; Hastings, Paul D; Prince, Conrad; Siedule, Connie

2013-01-01

There are few health promotion tools for urban Inuit, and there is a specific dearth of evaluations on such tools. The current study used a community-specific approach in the evaluation of a health promotion tool, based on an urban Inuit community's preferences of health knowledge sources and distribution strategies. In partnership with the Tungasuvvingat Inuit Family Health Team in Ottawa, a CD-Rom was developed featuring an Inuk Elder presenting prenatal health messages in both Inuktitut and English. Also, relevant evaluation materials were developed. Using a mixed methods approach, 40 participants completed interviews prior to viewing the CD-Rom and participated in a focus group at follow-up. Questionnaires were also completed pre- and post-viewing to assess changes between expectations and reactions in order to document acceptability. Significant increases were found on satisfaction, acceptability of medium and relevance of content ratings. Qualitative findings also included (a) interest, uncertainty and conditional interest prior to viewing; and (b) positive evaluations of the CD-Rom. This suggests that CD-Rom technology has the potential for health promotion for urban Inuit, and the community-specific evaluation approach yielded useful information.

Evaluation of the acceptability of a CD-Rom as a health promotion tool for Inuit in Ottawa

PubMed Central

McShane, Kelly E.; Smylie, Janet K.; Hastings, Paul D.; Prince, Conrad; Siedule, Connie

2013-01-01

Background There are few health promotion tools for urban Inuit, and there is a specific dearth of evaluations on such tools. Objective The current study used a community-specific approach in the evaluation of a health promotion tool, based on an urban Inuit community's preferences of health knowledge sources and distribution strategies. In partnership with the Tungasuvvingat Inuit Family Health Team in Ottawa, a CD-Rom was developed featuring an Inuk Elder presenting prenatal health messages in both Inuktitut and English. Also, relevant evaluation materials were developed. Design Using a mixed methods approach, 40 participants completed interviews prior to viewing the CD-Rom and participated in a focus group at follow-up. Questionnaires were also completed pre- and post-viewing to assess changes between expectations and reactions in order to document acceptability. Results Significant increases were found on satisfaction, acceptability of medium and relevance of content ratings. Qualitative findings also included (a) interest, uncertainty and conditional interest prior to viewing; and (b) positive evaluations of the CD-Rom. Conclusions This suggests that CD-Rom technology has the potential for health promotion for urban Inuit, and the community-specific evaluation approach yielded useful information. PMID:23717816

Newcomers health in Brantford and the counties of Brant, Haldimand and Norfolk: perspectives of newcomers and service providers.

PubMed

Sethi, Bharati

2013-10-01

The Canadian government's plan to support a balanced distribution of immigrants throughout the nation has contributed to newcomers' dispersion to small town communities and rural areas. However, very little work has examined the health experiences of immigrants settling in smaller urban and rural regions. Even less literature exists on the perspectives of service providers working with newcomers in Canada's urban-rural communities. This paper focuses on a part of a larger Community-based study on 'Newcomer Settlement and Integration in Education, Training, Employment, Health and Social Support' in Brantford--a middle-sized urban/rural region in Ontario, Canada--and discusses the findings in the health domain. Data were generated from 212 service providers and 237 newcomers using both qualitative and quantitative research tools. Newcomers identified several barriers in accessing mental and/or physical health services including lack of culturally appropriate services and discrimination. The striking differences between newcomers' and service providers' responses to the survey questionnaires bring to light cultural variations between the newcomers' and the service providers' perceptions of 'health'. The findings reinforce the need for including newcomers in developing more inclusive and culturally-appropriate health services and programs.

Rural physicians, rural networks, and free market health care in the 1990s.

PubMed

Rosenthal, T C; James, P; Fox, C; Wysong, J; FitzPatrick, P G

1997-01-01

The changes brought about by managed care in America's urban communities will have profound effects on rural physicians and hospitals. The rural health care market characterized by small, independent group practices working with community hospitals is being offered affiliations with large, often urban-based health care organizations. Health care is evolving into a free market system characterized by large networks of organizations capable of serving whole regions. Rural provider-initiated networks can assure local representation when participating in the new market and improve the rural health infrastructure. Although an extensive review of the literature from 1970 to 1996 reveals little definitive research about networks, many rural hospitals have embraced networking as one strategy to unify health care systems with minimal capitalization. These networks, now licensed in Minnesota and New York, offer rural physicians the opportunity to team up with their community hospital and enhance local health care accessibility.

Multilevel examination of the association of urbanization with inflammation in Chinese adults

PubMed Central

Thompson, Amanda L.; Houck, Kelly M.; Adair, Linda; Gordon-Larsen, Penny; Popkin, Barry

2014-01-01

We examine the associations between overall urbanicity and specific physical and social components of community-level urbanization with C-reactive protein (CRP) in adults participating in the China Health and Nutrition Study. Higher overall urbanicity and environment-related urbanicity component scores, including education, housing quality, and access to markets, were associated with elevated CRP in multilevel models controlling for clustering by community. These associations differed by age and gender and persisted after controlling for individual-level anthropometric, diet, and pathogenic risk factors. These results highlight the importance of place in relation to inflammation across the spectrum of rural and urban environments. PMID:24908386

Child Nutritional Status by Rural/Urban Residence: A Cross-National Analysis

ERIC Educational Resources Information Center

Fox, Kiira; Heaton, Tim B.

2012-01-01

Purpose: Rural children in developing countries have poor health outcomes in comparison with urban children. This paper considers 4 questions regarding the rural/urban difference, namely: (1) do individual-level characteristics account for rural/urban differences in child nutritional status; (2) do community-level characteristics account for…

Landscape designers, doctors, and the making of healthy urban spaces in 19th century America

Treesearch

Robert Martensen

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Creating Mechanisms for Meaningful Collaboration Between Members of Urban Communities and University-Based HIV Prevention Researchers.

PubMed

McKay, Mary M; Hibbert, Richard; Lawrence, Rita; Miranda, Ana; Paikoff, Roberta; Bell, Carl C; Madison-Boyd, Sybil; Baptiste, Donna; Coleman, Doris; Pinto, Rogério M; Bannon, William M

2007-01-01

This article provides a description of a Community/University Collaborative Board, a formalized partnership between representatives from an inner-city community and university-based researchers. This Collaborative Board oversees a number of research projects focused on designing, delivering and testing family-based HIV prevention and mental health focused programs to elementary and junior high school age youth and their families. The Collaborative Board consists of urban parents, school staff members, representatives from community-based agencies and university-based researchers. One research project, the CHAMP (Collaborative HIV prevention and Adolescent Mental health Project) Family Program Study, an urban, family-based HIV prevention project will be used to illustrate how the Collaborative Board oversees a community-based research study. The process of establishing a Collaborative Board, recruiting members and developing subcommittees is described within this article. Examples of specific issues addressed by the Collaborative Board within its subcommittees, Implementation, Finance, Welcome, Research, Grant writing, Curriculum, and Leadership, are detailed in this article along with lessons learned.

[Health education and people's participation in health in Nicaragua: research on the profile, role and function of the "brigadistas populares" in health].

PubMed

Leonardi, L; Mori, M

1989-01-01

The Nicaraguan democratic government has been building, since the defeat of somozism in 1979, a very extensive and uniform health system in the whole country, giving special attention to the problems of prevention and health education, promoting and utilizing a wide participation of the population. The most emblematic representative of the Nicaraguan model of participation is the Brigadista Popular en Salud, a voluntary figure in urban and rural areas, working along side the Sole National Health System. The work and role of the Brigadista is integrated in a health education action defined "Educaciòn Popular en Salud", intended as a dialogue through which the educator and educated, beginning with the specific political and economical social reality, accomplish work of observation, analysis and syntesis of the different phenomena that deal with health-sickness. The Brigadista is a member of the community that works voluntarily for the community to carry out health actions, in coordination with the "Puesto de Salud" of the community. The authors refer to a research study done in the field in 1987, geared to study the profile, role and activities of the Brigadista. The research was done in the "Las Segovias" Region, in the Northern part of the country, in two Health Areas, involving three urban centers and six rural communities: 73 Brigadistas were interviewed, of which 50 (predetermined) of urban centers and 23 (total population) in rural communities. The article represents in a comparative manner the operative Brigadista respectively, in urban areas on the one hand and in rural areas on the other. The article examines: sex; age; schooling; work activity; social-cultural background; collective systems background; participation in Literacy Campaigns; motivation; length and continuity of activities; relationship with the territory; activities done. The Brigadista that works in rural areas seems actually to be more attached, even to the formal image of his role, that the urban Brigadista. This is shown by the reduced turn-over, the wider span of functions, the closer relationship with collective systems that represent categories, a more intense relationship with colleagues of the health system as well as with other Brigadistas, the operative reference to specificity defined territories, more continuity in the functions of the Brigadista Popular en Salud.

Community Violence, Protective Factors, and Adolescent Mental Health: A Profile Analysis

ERIC Educational Resources Information Center

Copeland-Linder, Nikeea; Lambert, Sharon F.; Ialongo, Nicholas S.

2010-01-01

This study examined interrelationships among community violence exposure, protective factors, and mental health in a sample of urban, predominantly African American adolescents (N = 504). Latent Profile Analysis was conducted to identify profiles of adolescents based on a combination of community violence exposure, self-worth, parental monitoring,…

Factors Influencing the Health and Wellness of Urban Aboriginal Youths in Canada: Insights of In-Service Professionals, Care Providers, and Stakeholders

PubMed Central

Yi, Kyoung June; Landais, Edwige; Kolahdooz, Fariba

2015-01-01

We addressed the positive and negative factors that influence the health and wellness of urban Aboriginal youths in Canada and ways of restoring, promoting, and maintaining the health and wellness of this population. Fifty-three in-service professionals, care providers, and stakeholders participated in this study in which we employed the Glaserian grounded theory approach. We identified perceived positive and negative factors. Participants suggested 5 approaches—(1) youth based and youth driven, (2) community based and community driven, (3) culturally appropriate, (4) enabling and empowering, and (5) sustainable—as well as some practical strategies for the development and implementation of programs. We have provided empirical knowledge about barriers to and opportunities for improving health and wellness among urban Aboriginal youths in Canada. PMID:25790390

How Service Learning Addresses the Mental Health Needs of Students in Urban Schools

ERIC Educational Resources Information Center

Wilczenski, Felicia L.; Cook, Amy L.

2009-01-01

Service learning promotes social-emotional and academic development through active engagement in community activities. It empowers students to think beyond themselves and to develop a commitment to serve others. In so doing, service learning builds connections with school and community that are critically important in urban settings. This paper…

Human resource for health reform in peri-urban areas: a cross-sectional study of the impact of policy interventions on healthcare workers in Epworth, Zimbabwe.

PubMed

Taderera, Bernard Hope; Hendricks, Stephen James Heinrich; Pillay, Yogan

2017-12-16

The need to understand how healthcare worker reform policy interventions impact health personnel in peri-urban areas is important as it also contributes towards setting of priorities in pursuing the universal health coverage goal of health sector reform. This study explored the impact of post 2008 human resource for health reform policy interventions on healthcare workers in Epworth, a peri-urban community in Harare, Zimbabwe, and the implications towards health sector reform policy in peri-urban areas. The study design was exploratory and cross-sectional and involved the use of qualitative and quantitative methods in data collection, presentation, and analysis. A qualitative study in which data were collected through a documentary search, five key informant interviews, seven in-depth interviews, and five focus group discussions was carried out first. This was followed by a quantitative study in which data were collected through a documentary search and 87 semi-structured sample interviews with healthcare workers. Qualitative data were analyzed thematically whilst descriptive statistics were used to examine quantitative data. All data were integrated during analysis to ensure comprehensive, reliable, and valid analysis of the dataset. Three main factors were identified to help interpret findings. The first main factor consisted policy result areas that impacted most successfully on healthcare workers. These included the deployment of community health workers with the highest correlation of 0.83. Policy result areas in the second main factor included financial incentives with a correlation of 0.79, training and development (0.77), deployment (0.77), and non-financial incentives (0.75). The third factor consisted policy result areas that had the lowest satisfaction amongst healthcare workers in Epworth. These included safety (0.72), equipment and tools of trade (0.72), health welfare (0.65), and salaries (0.55). The deployment of community health volunteers impacted healthcare workers most successfully. This was followed by salary top-up allowances, training, deployment, and non-financial incentives. However, health personnel were least satisfied with their salaries. This had negative implications towards health sector reform interventions in Epworth peri-urban community between 2009 and 2014.

Effects of individual, household and community characteristics on child nutritional status in the slums of urban Bangladesh.

PubMed

Ahsan, Karar Zunaid; Arifeen, Shams El; Al-Mamun, Md Abdullah; Khan, Shusmita H; Chakraborty, Nitai

2017-01-01

Bangladesh urban population is expected to overtake rural population by 2040, and a significant part of the increase will be in slums. Wide disparities between urban slums and the rest of the country can potentially push country indicators off track unless the specific health and nutrition needs of the expanding slum communities are addressed. The study aims at describing the individual, household and community determinants of undernutrition status among children living in major urban strata, viz. City Corporation slums and non-slums, in order to understand the major drivers of childhood undernutrition in urban slum settings. Data are derived from Bangladesh Urban Health Survey conducted in 2013. This survey is a large-scale, nationally representative of urban areas, household survey designed specifically to provide health and nutrition status of women and children in urban Bangladesh. Data showed that 50% of under-5 children in slums are stunted and 43% are underweight, whereas for non-slums these rates are 33 and 26% respectively. In terms of severity, proportion of under-5 children living in slums severely underweight or stunted are nearly double than the children living in non-slums. Logistic analyses indicate that mother's education, child's age, and household's socio-economic status significantly affects stunting and underweight levels among children living in the urban slums. Logistic models also indicate that all individual-level characteristics, except exposure to mass media and mother's working outside home, significantly affect undernutrition levels among children living on non-slums. Among the household- and community-level characteristics, only household's socioeconomic status remains significant for the non-slums. Poor nutritional status is a major concern in slum areas, particularly as this group is expected to grow rapidly in the next few years. The situation calls for specially designed and well targeted interventions that take into account that many of the mothers are poorer and less educated, which affects their ability to provide care to their children.

Increasing Pap smear rates at an urban Aboriginal Community Controlled Health Service through translational research and continuous quality improvement.

PubMed

Dorrington, Melanie S; Herceg, Ana; Douglas, Kirsty; Tongs, Julie; Bookallil, Marianne

2015-01-01

This article describes translational research (TR) and continuous quality improvement (CQI) processes used to identify and address barriers and facilitators to Pap smear screening within an urban Aboriginal Community Controlled Health Service (ACCHS). Rapid Plan-Do-Study-Act (PDSA) cycles were conducted, informed by client surveys, a data collection tool, focus groups and internal research. There was a statistically significant increase in Pap smear numbers during PDSA cycles, continuing at 10 months follow up. The use of TR with CQI appears to be an effective and acceptable way to affect Pap smear screening. Community and service collaboration should be at the core of research in Aboriginal and Torres Strait Islander health settings. This model is transferrable to other settings and other health issues.

Community as client: reaching an underserved urban community and meeting unmet primary health care needs.

PubMed

Aponte, Judith; Nickitas, Donna M

2007-01-01

In a collaborative effort to address the health disparities within 1 urban underserved community, the Hunter-Bellevue School of Nursing, Hunter College, and the Mount Sinai Medical Center organized a health fair. Nursing faculty worked side by side with undergraduate nursing students to offer several health promotion activities, screening, and educational sessions for residents of East Harlem, New York. In addition, nursing students provided individual patient education on nutrition, hand washing hygiene, medication review, and glucometer usage. Educational materials on lifestyle issues (sample meals, maintaining normal blood glucose, blood pressure, cholesterol levels, and smoking cessation) were provided. To help bridge the gap between health education and health promotion activities, nursing students, many of whom were bilingual, served as translators for non-English speaking Spanish and Chinese residents. In addition to the new professional partnerships developed, new clinical placements for nursing students were established.

Substance abuse prevention in Cape Town's peri-urban settlements: local health trainers' perspectives

PubMed Central

Puljević, Cheneal; Learmonth, Despina

2014-01-01

South Africa currently experiences high levels of alcohol and other drug (AOD) abuse. As a result there is a need for the initiation of regional AOD abuse prevention programmes with a specific focus on youth prevention strategies. The Medical Knowledge Institute (MKI) is a non-profit organisation which develops and facilitates health information workshops to members of disadvantaged peri-urban communities in South Africa. This research investigated the views of eight local MKI health trainers on factors contributing to AOD abuse in their communities. Although the expected focus of the discussion was on prevention strategies and effective interventions, the trainers placed more emphasis on the individual and community factors influencing AOD abuse. The themes which emerged through the research included: status, government, (di)stress, gender, recreation, consequences and community. This research holds significance as it has the potential to assist further development of community-based AOD prevention workshops and to guide public health policy and service development for AOD abuse. PMID:25750776

A Participatory Action Research Pilot Study of Urban Health Disparities Using Rapid Assessment Response and Evaluation

PubMed Central

Brown, David Richard; Hernández, Agueda; Saint-Jean, Gilbert; Evans, Siân; Tafari, Ida; Brewster, Luther G.; Celestin, Michel J.; Gómez-Estefan, Carlos; Regalado, Fernando; Akal, Siri; Nierenberg, Barry; Kauschinger, Elaine D.; Schwartz, Robert; Page, J. Bryan

2008-01-01

Healthy People 2010 made it a priority to eliminate health disparities. We used a rapid assessment response and evaluation (RARE) to launch a program of participatory action research focused on health disparities in an urban, disadvantaged Black community serviced by a major south Florida health center. We formed partnerships with community members, identified local health disparities, and guided interventions targeting health disparities. We describe the RARE structure used to triangulate data sources and guide intervention plans as well as findings and conclusions drawn from scientific literature and epidemiological, historic, planning, clinical, and ethnographic data. Disenfranchisement and socioeconomic deprivation emerged as the principal determinants of local health disparities and the most appropriate targets for intervention. PMID:18048802

[A good investment: promoting health in cities and neighbourhoods].

PubMed

Díez, Elia; Aviñó, Dory; Paredes-Carbonell, Joan J; Segura, Javier; Suárez, Óscar; Gerez, Maria Dolores; Pérez, Anna; Daban, Ferran; Camprubí, Lluís

2016-11-01

Local administration is responsible for health-related areas, and evidence of the health impact of urban policies is available. Barriers and recommendations for the full implementation of health promotion in cities and neighbourhoods have been described. The barriers to the promotion of urban health are broad: the lack of leadership and political will, reflectes the allocation of health outcomes to health services, as well as technical, political and public misconceptions about the root causes of health and wellbeing. Ideologies and prejudices, non-evidence-based policies, narrow sectoral cultures, short political periods, lack of population-based health information and few opportunities for participation limit the opportunities for urban health. Local policies on early childhood, healthy schools, employment, active transport, parks, leisure and community services, housing, urban planning, food protection and environmental health have great positive impacts on health. Key tools include the political prioritisation of health and equity, the commitment to «Health in All Policies» and the participation of communities, social movements and civil society. This requires well organised and funded structures and processes, as well as equity-based health information and capacity building in the health sector, other sectors and society. We conclude that local policies have a great potential for maximising health and equity and equity. The recommendations for carrying them out are increasingly solid and feasible. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey.

PubMed

Gopalan, Anjali; Makelarski, Jennifer A; Garibay, Lori B; Escamilla, Veronica; Merchant, Raina M; Wolfe, Marcus B; Holbrook, Rebecca; Lindau, Stacy Tessler

2016-06-28

More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may substitute for or complement community-based resources for weight management. However, little is currently known about health-specific ICT use among urban-dwelling people with obesity. We describe health-specific ICT use and its relationship to measured obesity among adults in high-poverty urban communities. Using data collected between November 2012 and July 2013 from a population-based probability sample of urban-dwelling African American and Hispanic adults residing on the South Side of Chicago, we described patterns of ICT use in relation to measured obesity defined by a body mass index (BMI) of ≥30 kg/m(2). Among those with BMI≥30 kg/m(2), we also assessed the association between health-specific ICT use and diagnosed versus undiagnosed obesity as well as differences in health-specific ICT use by self-reported comorbidities, including diabetes and hypertension. The survey response rate was 44.6% (267 completed surveys/598.4 eligible or likely eligible individuals); 53.2% were African American and 34.6% were Hispanic. More than 35% of the population reported an annual income of less than US $25,000. The population prevalence of measured obesity was 50.2%. People with measured obesity (BMI≥30 kg/m(2)) were more likely to report both general (81.5% vs 67.0%, P=.04) and health-specific (61.1% vs 41.2%, P=.01) ICT use. In contrast, among those with measured obesity, being told of this diagnosis by a physician was not associated with increased health-specific ICT use. People with measured obesity alone had higher rates of health-specific use than those with comorbid hypertension and/or diabetes diagnoses (77.1% vs 60.7% vs 47.4%, P=.04). In conclusion, ICT-based health resources may be particularly useful for people in high-poverty urban communities with isolated measured obesity, a population that is at high risk for poor health outcomes.

Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey

PubMed Central

Makelarski, Jennifer A; Garibay, Lori B; Escamilla, Veronica; Merchant, Raina M; Wolfe Sr, Marcus B; Holbrook, Rebecca; Lindau, Stacy Tessler

2016-01-01

Background More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may substitute for or complement community-based resources for weight management. However, little is currently known about health-specific ICT use among urban-dwelling people with obesity. Objective We describe health-specific ICT use and its relationship to measured obesity among adults in high-poverty urban communities. Methods Using data collected between November 2012 and July 2013 from a population-based probability sample of urban-dwelling African American and Hispanic adults residing on the South Side of Chicago, we described patterns of ICT use in relation to measured obesity defined by a body mass index (BMI) of ≥30 kg/m2. Among those with BMI≥30 kg/m2, we also assessed the association between health-specific ICT use and diagnosed versus undiagnosed obesity as well as differences in health-specific ICT use by self-reported comorbidities, including diabetes and hypertension. Results The survey response rate was 44.6% (267 completed surveys/598.4 eligible or likely eligible individuals); 53.2% were African American and 34.6% were Hispanic. More than 35% of the population reported an annual income of less than US $25,000. The population prevalence of measured obesity was 50.2%. People with measured obesity (BMI≥30 kg/m2) were more likely to report both general (81.5% vs 67.0%, P=.04) and health-specific (61.1% vs 41.2%, P=.01) ICT use. In contrast, among those with measured obesity, being told of this diagnosis by a physician was not associated with increased health-specific ICT use. People with measured obesity alone had higher rates of health-specific use than those with comorbid hypertension and/or diabetes diagnoses (77.1% vs 60.7% vs 47.4%, P=.04). Conclusions In conclusion, ICT-based health resources may be particularly useful for people in high-poverty urban communities with isolated measured obesity, a population that is at high risk for poor health outcomes. PMID:27352770

Microbial biomass carbon and enzyme activities of urban soils in Beijing.

PubMed

Wang, Meie; Markert, Bernd; Shen, Wenming; Chen, Weiping; Peng, Chi; Ouyang, Zhiyun

2011-07-01

To promote rational and sustainable use of soil resources and to maintain the urban soil quality, it is essential to assess urban ecosystem health. In this study, the microbiological properties of urban soils in Beijing and their spatial distribution patterns across the city were evaluated based on measurements of microbial biomass carbon and urease and invertase activities of the soils for the purpose of assessing the urban ecosystem health of Beijing. Grid sampling design, normal Kriging technique, and the multiple comparisons among different land use types were used in soil sampling and data treatment. The inherent chemical characteristics of urban soils in Beijing, e.g., soil pH, electronic conductivity, heavy metal contents, total N, P and K contents, and soil organic matter contents were detected. The size and diversity of microbial community and the extent of microbial activity in Beijing urban soils were measured as the microbial biomass carbon content and the ratio of microbial biomass carbon content to total soil organic carbon. The microbial community health measured in terms of microbial biomass carbon, urease, and invertase activities varied with the organic substrate and nutrient contents of the soils and were not adversely affected by the presence of heavy metals at p < 0.01. It was shown that the older and the biologically more stable part of city exhibited higher microbial activity levels than the more recently developed part of the city and the road areas of heavy traffic. It was concluded that the land use patterns in Beijing urban soils influenced the nature and activities of the microbial communities.

Population Density and AIDS-Related Stigma in Large-Urban, Small-Urban, and Rural Communities of the Southeastern USA.

PubMed

Kalichman, Seth; Katner, Harold; Banas, Ellen; Kalichman, Moira

2017-07-01

AIDS stigmas delay HIV diagnosis, interfere with health care, and contribute to mental health problems among people living with HIV. While there are few studies of the geographical distribution of AIDS stigma, research suggests that AIDS stigmas are differentially experienced in rural and urban areas. We conducted computerized interviews with 696 men and women living with HIV in 113 different zip code areas that were classified as large-urban, small-urban, and rural areas in a southeast US state with high-HIV prevalence. Analyses conducted at the individual level (N = 696) accounting for clustering at the zip code level showed that internalized AIDS-related stigma (e.g., the sense of being inferior to others because of HIV) was experienced with greater magnitude in less densely populated communities. Multilevel models indicated that after adjusting for potential confounding factors, rural communities reported greater internalized AIDS-related stigma compared to large-urban areas and that small-urban areas indicated greater experiences of enacted stigma (e.g., discrimination) than large-urban areas. The associations between anticipated AIDS-related stigma (e.g., expecting discrimination) and population density at the community-level were not significant. Results suggest that people living in rural and small-urban settings experience greater AIDS-related internalized and enacted stigma than their counterparts living in large-urban centers. Research is needed to determine whether low-density population areas contribute to or are sought out by people who experienced greater AIDS-related stigma. Regardless of causal directions, interventions are needed to address AIDS-related stigma, especially among people in sparsely populated areas with limited resources.

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities

PubMed Central

Roe, Jenny; Aspinall, Peter A.; Ward Thompson, Catharine

2016-01-01

Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from “very good” health (people of Indian origin), to ”good” health (white British), and ”poor” health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled ”Mixed BME” in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in ”Mixed BME”. Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an important role in helping address the health inequalities experienced by these groups. PMID:27399736

Understanding Relationships between Health, Ethnicity, Place and the Role of Urban Green Space in Deprived Urban Communities.

PubMed

Roe, Jenny; Aspinall, Peter A; Ward Thompson, Catharine

2016-07-05

Very little is known about how differences in use and perceptions of urban green space impact on the general health of black and minority ethnic (BME) groups. BME groups in the UK suffer from poorer health and a wide range of environmental inequalities that include poorer access to urban green space and poorer quality of green space provision. This study used a household questionnaire (n = 523) to explore the relationship between general health and a range of individual, social and physical environmental predictors in deprived white British and BME groups living in ethnically diverse cities in England. Results from Chi-Squared Automatic Interaction Detection (CHAID) segmentation analyses identified three distinct general health segments in our sample ranging from "very good" health (people of Indian origin), to "good" health (white British), and "poor" health (people of African-Caribbean, Bangladeshi, Pakistani origin and other BME groups), labelled "Mixed BME" in the analyses. Correlated Component Regression analyses explored predictors of general health for each group. Common predictors of general health across all groups were age, disability, and levels of physical activity. However, social and environmental predictors of general health-including use and perceptions of urban green space-varied among the three groups. For white British people, social characteristics of place (i.e., place belonging, levels of neighbourhood trust, loneliness) ranked most highly as predictors of general health, whilst the quality of, access to and the use of urban green space was a significant predictor of general health for the poorest health group only, i.e., in "Mixed BME". Results are discussed from the perspective of differences in use and perceptions of urban green space amongst ethnic groups. We conclude that health and recreation policy in the UK needs to give greater attention to the provision of local green space amongst poor BME communities since this can play an important role in helping address the health inequalities experienced by these groups.

Teaching Tradition: Diverse Perspectives on the Pilot Urban American Indian Traditional Spirituality Program.

PubMed

Gone, Joseph P; Blumstein, Katherine P; Dominic, David; Fox, Nickole; Jacobs, Joan; Lynn, Rebecca S; Martinez, Michelle; Tuomi, Ashley

2017-06-01

Many urban American Indian community members lack access to knowledgeable participation in indigenous spiritual practices. And yet, these sacred traditional activities remain vitally important to their reservation-based kin. In response, our research team partnered with an urban American Indian health center in Detroit for purposes of developing a structured program to facilitate more ready access to participation in indigenous spiritual knowledge and practices centered on the sweat lodge ceremony. Following years of preparation and consultation, we implemented a pilot version of the Urban American Indian Traditional Spirituality Program in the spring of 2016 for 10 urban AI community participants. Drawing on six first-person accounts about this program, we reflect on its success as a function of participant meaningfulness, staff support, mitigated sensitivities, and program structure. We believe that these observations will enable other community psychologists to undertake similar program development in service to innovative and beneficial impacts on behalf of their community partners. © Society for Community Research and Action 2017.

Using Geospatial Research Methods to Examine Resource Accessibility and Availability as it Relates to Community Participation of Individuals with Serious Mental Illnesses.

PubMed

Townley, Greg; Brusilovskiy, Eugene; Snethen, Gretchen; Salzer, Mark S

2018-03-01

Greater community participation among individuals with serious mental illnesses is associated with better psychosocial and health outcomes. Typically, studies examining community participation have utilized self-report measures and been conducted in limited settings. The introduction of methodological advances to examining community participation of individuals with serious mental illnesses has the potential to advance the science of community mental health research and invigorate the work of community psychologists in this area. This study employed an innovative geospatial approach to examine the relationship between community participation and resource accessibility (i.e., proximity) and availability (i.e., concentration) among 294 individuals utilizing community mental health services throughout the United States. Findings suggest small but significant associations between community participation and the accessibility and availability of resources needed for participation. Furthermore, findings demonstrate the importance of car access for individuals residing in both urban and non-urban settings. The methods and results presented in this study have implications for community mental health research and services and provide an illustration of ways that geospatial methodologies can be used to investigate environmental factors that impact community inclusion and participation of individuals with serious mental illnesses. © Society for Community Research and Action 2017.

Transforming the urban food desert from the grassroots up: a model for community change.

PubMed

Lewis, LaVonna Blair; Galloway-Gilliam, Lark; Flynn, Gwendolyn; Nomachi, Jonathan; Keener, LaTonya Chavis; Sloane, David C

2011-01-01

Confronted by continuing health disparities in vulnerable communities, Community Health Councils (CHC), a nonprofit community-based organization in South Los Angeles, worked with the African Americans Building a Legacy of Health Coalition and research partners to develop a community change model to address the root causes of health disparities within the community's African American population. This article discusses how the CHC Model's development and application led to public policy interventions in a "food desert." The CHC Model provided a systematic approach to engaging impacted communities in support of societal level reforms, with the goal to influence health outcomes.

Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina.

PubMed

Carter-Edwards, Lori; Lowe-Wilson, Abby; Mouw, Mary Sherwyn; Jeon, Janet Yewon; Baber, Ceola Ross; Vu, Maihan B; Bethell, Monique

2015-08-13

The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state's most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing. In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity-related issues. Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts. Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies.

Community Member and Stakeholder Perspectives on a Healthy Environment Initiative in North Carolina

PubMed Central

Lowe-Wilson, Abby; Mouw, Mary Sherwyn; Jeon, Janet Yewon; Baber, Ceola Ross; Vu, Maihan B.; Bethell, Monique

2015-01-01

Introduction The North Carolina Community Transformation Grant Project (NC-CTG) aimed to implement policy, system, and environmental strategies to promote healthy eating, active living, tobacco-free living, and clinical and community preventive services to advance health equity and reduce health disparities for the state’s most vulnerable communities. This article presents findings from the Health Equity Collaborative Evaluation and Implementation Project, which assessed community and stakeholder perceptions of health equity for 3 NC-CTG strategies: farmers markets, shared use, and smoke-free multiunit housing. Methods In a triangulated qualitative evaluation, 6 photo elicitation (PE) sessions among 45 community members in 1 urban and 3 rural counties and key informant interviews among 22 stakeholders were conducted. Nine participants from the PE sessions and key informant interviews in the urban county subsequently participated in a stakeholder power analysis and mapping session (SPA) to discuss and identify people and organizations in their community perceived to be influential in addressing health equity–related issues. Results Evaluations of the PE sessions and key informant interviews indicated that access (convenience, cost, safety, and awareness of products and services) and community fit (community-defined quality, safety, values, and norms) were important constructs across the strategies. The SPA identified specific community- and faith-based organizations, health care organizations, and local government agencies as key stakeholders for future efforts. Conclusions Both community fit and access are essential constructs for promoting health equity. Findings demonstrate the feasibility of and need for formative research that engages community members and local stakeholders to shape context-specific, culturally relevant health promotion strategies. PMID:26270741

Urban forests

Treesearch

David J. Nowak; Eric J. Greenfield

2016-01-01

Trees and forests are resources that significantly affect the health and well-being of people who live in urban areas where more than 80 percent of the U.S. population resides. These trees within our cities and communities provide many ecosystem services and values to both urban and rural populations. Healthy urban and rural forests are critical for sustaining quality...

Neighbors United for Health

ERIC Educational Resources Information Center

Westhoff, Wayne W.; Corvin, Jaime; Virella, Irmarie

2009-01-01

Modeled upon the ecclesiastic community group concept of Latin America to unite and strengthen the bond between the Church and neighborhoods, a community-based organization created Vecinos Unidos por la Salud (Neighbors United for Health) to bring health messages into urban Latino neighborhoods. The model is based on five tenants, and incorporates…

Urban community gardeners' knowledge and perceptions of soil contaminant risks.

PubMed

Kim, Brent F; Poulsen, Melissa N; Margulies, Jared D; Dix, Katie L; Palmer, Anne M; Nachman, Keeve E

2014-01-01

Although urban community gardening can offer health, social, environmental, and economic benefits, these benefits must be weighed against the potential health risks stemming from exposure to contaminants such as heavy metals and organic chemicals that may be present in urban soils. Individuals who garden at or eat food grown in contaminated urban garden sites may be at risk of exposure to such contaminants. Gardeners may be unaware of these risks and how to manage them. We used a mixed quantitative/qualitative research approach to characterize urban community gardeners' knowledge and perceptions of risks related to soil contaminant exposure. We conducted surveys with 70 gardeners from 15 community gardens in Baltimore, Maryland, and semi-structured interviews with 18 key informants knowledgeable about community gardening and soil contamination in Baltimore. We identified a range of factors, challenges, and needs related to Baltimore community gardeners' perceptions of risk related to soil contamination, including low levels of concern and inconsistent levels of knowledge about heavy metal and organic chemical contaminants, barriers to investigating a garden site's history and conducting soil tests, limited knowledge of best practices for reducing exposure, and a need for clear and concise information on how best to prevent and manage soil contamination. Key informants discussed various strategies for developing and disseminating educational materials to gardeners. For some challenges, such as barriers to conducting site history and soil tests, some informants recommended city-wide interventions that bypass the need for gardener knowledge altogether.

Urban Community Gardeners' Knowledge and Perceptions of Soil Contaminant Risks

PubMed Central

Kim, Brent F.; Poulsen, Melissa N.; Margulies, Jared D.; Dix, Katie L.; Palmer, Anne M.; Nachman, Keeve E.

2014-01-01

Although urban community gardening can offer health, social, environmental, and economic benefits, these benefits must be weighed against the potential health risks stemming from exposure to contaminants such as heavy metals and organic chemicals that may be present in urban soils. Individuals who garden at or eat food grown in contaminated urban garden sites may be at risk of exposure to such contaminants. Gardeners may be unaware of these risks and how to manage them. We used a mixed quantitative/qualitative research approach to characterize urban community gardeners' knowledge and perceptions of risks related to soil contaminant exposure. We conducted surveys with 70 gardeners from 15 community gardens in Baltimore, Maryland, and semi-structured interviews with 18 key informants knowledgeable about community gardening and soil contamination in Baltimore. We identified a range of factors, challenges, and needs related to Baltimore community gardeners' perceptions of risk related to soil contamination, including low levels of concern and inconsistent levels of knowledge about heavy metal and organic chemical contaminants, barriers to investigating a garden site's history and conducting soil tests, limited knowledge of best practices for reducing exposure, and a need for clear and concise information on how best to prevent and manage soil contamination. Key informants discussed various strategies for developing and disseminating educational materials to gardeners. For some challenges, such as barriers to conducting site history and soil tests, some informants recommended city-wide interventions that bypass the need for gardener knowledge altogether. PMID:24516570

Urban American Indian Community Perspectives on Resources and Challenges for Youth Suicide Prevention.

PubMed

Burrage, Rachel L; Gone, Joseph P; Momper, Sandra L

2016-09-01

American Indian (AI) youth have some of the highest rates of suicide of any group in the United States, and the majority of AI youth live in urban areas away from tribal communities. As such, understanding the resources available for suicide prevention among urban AI youth is critical, as is understanding the challenges involved in accessing such resources. Pre-existing interview data from 15 self-identified AI community members and staff from an Urban Indian Health Organization were examined to understand existing resources for urban AI youth suicide prevention, as well as related challenges. A thematic analysis was undertaken, resulting in three principal themes around suicide prevention: formal resources, informal resources, and community values and beliefs. Formal resources that meet the needs of AI youth were viewed as largely inaccessible or nonexistent, and youth were seen as more likely to seek help from informal sources. Community values of mutual support were thought to reinforce available informal supports. However, challenges arose in terms of the community's knowledge of and views on discussing suicide, as well as the perceived fit between community values and beliefs and formal prevention models. © Society for Community Research and Action 2016.

Healthy Communities Grant Program | Urban Environmental ...

EPA Pesticide Factsheets

2018-03-06

The Healthy Communities Grant Program is EPA New England's main competitive grant program to work directly with communities to reduce environmental risks to protect and improve human health and the quality of life.

Building on Leadership and Social Capital to Create Change in 2 Urban Communities

PubMed Central

Farquhar, Stephanie A.; Michael, Yvonne L.; Wiggins, Noelle

2005-01-01

There has been an appeal to reduce health inequities by increasing community involvement and social capital. Poder es Salud/Power for Health is a community-based participatory prevention research project that seeks to address health disparities in the African American and Latino communities by enhancing community-level social capital. We provide specific examples of how this intervention uses community health workers and popular education to reduce language and cultural barriers and enhance community social capital. Although the communities share fundamental challenges related to health disparities, the ways in which the Latino and African American communities identify health concerns, create solutions, and think about social capital vary. Members of the project are working together to identify opportunities for cross-cultural collaboration. PMID:15798115

Mental health and gambling in urban female adolescents

PubMed Central

Martins, Silvia S.; Storr, Carla L.; Ialongo, Nicholas S.; Chilcoat, Howard D.

2007-01-01

This study explores differences in mental health and behavioral disturbances between female gamblers versus nongamblers from a community sample of 232 female urban youth. Female adolescent recreational gambling was associated with high levels of childhood hyperactivity measured at age 6, past-year substance use, and past-year anxiety symptoms. PMID:17448407

Development of a theater-based nutrition and physical activity intervention for low-income, urban, African American adolescents.

PubMed

Jackson, Caree J; Mullis, Rebecca M; Hughes, Marilyn

2010-01-01

Childhood overweight is disproportionately worse in minority and low-income populations. Theater is a promising and effective tool for delivering health education to these underserved populations, but no known studies have examined the use of theater to promote both nutrition and physical activity to minority youth. To develop an interactive, theater-based intervention that conveys health messages to low-income, urban, African Americans and engages them in learning ways to adopt a healthy lifestyle. Community partners worked to develop a theater-based nutrition and physical activity intervention. A focus group provided urban adolescents' thoughts about their desires for the intervention. Based on input from all community partners, the group created a theater-based intervention. Researchers used a quasi-experimental (pre-/posttest) design with a community-based participatory research (CBPR) approach. Participants learned health messages through theater, dance, and music and gave feedback on the program sessions and materials. The program ended with a dinner theater performance showcasing information that students learned during the intervention. Participants received six theater-based health lessons. Learning objectives for each health education session were achieved. Each participant contributed to and performed in the final performance. All program participants were highly satisfied with the theater-based method of learning health messages. A community-academic partnership succeeded in developing a theater-based nutrition and physical activity intervention that satisfied participating adolescents.

Health status and air pollution related socioeconomic concerns in urban China.

PubMed

Jiao, Kaishan; Xu, Mengjia; Liu, Meng

2018-02-05

China is experiencing environmental issues and related health effects due to its industrialization and urbanization. The health effects associated with air pollution are not just a matter of epidemiology and environmental science research, but also an important social science issue. Literature about the relationship of socioeconomic factors with the environment and health factors is inadequate. The relationship between air pollution exposure and health effects in China was investigated with consideration of the socioeconomic factors. Based on nationwide survey data of China in 2014, we applied the multilevel mixed-effects model to evaluate how socioeconomic status (represented by education and income) contributed to the relationship between self-rated air pollution and self-rated health status at community level and individual level. The findings indicated that there was a non-linear relationship between the community socioeconomic status and community air pollution in urban China, with the highest level of air pollution presented in the communities with moderate socioeconomic status. In addition, health effects associated air pollution in different socioeconomic status groups were not equal. Self-rated air pollution had the greatest impact on self-rated health of the lower socioeconomic groups. With the increase of socioeconomic status, the effect of self-rated air pollution on self-rated health decreased. This study verified the different levels of exposure to air pollution and inequality in health effects among different socioeconomic groups in China. It is imperative for the government to urgently formulate public policies to enhance the ability of the lower socioeconomic groups to circumvent air pollution and reduce the health damage caused by air pollution.

Utilization of Maternal and Child Health Care Services by Primigravida Females in Urban and Rural Areas of India

PubMed Central

2014-01-01

Maternal complications and poor perinatal outcome are highly associated with nonutilisation of antenatal and delivery care services and poor socioeconomic conditions of the patient. It is essential that all pregnant women have access to high quality obstetric care throughout their pregnancies. Present longitudinal study was carried out to compare utilization of maternal and child health care services by urban and rural primigravida females. A total of 240 study participants were enrolled in this study. More illiteracy and less mean age at the time of marriage were observed in rural population. Poor knowledge about prelacteal feed, colostrums, tetanus injection and iron-follic acid tablet consumption was noted in both urban and rural areas. Very few study participants from both areas were counselled for HIV testing before pregnancy. More numbers of abortions (19.2%) were noted in urban study participants compared to rural area. Thus utilization of maternal and child health care (MCH) services was poor in both urban and rural areas. A sustained and focussed IEC campaign to improve the awareness amongst community on MCH will help in improving community participation. This may improve the quality, accessibility, and utilization of maternal health care services provided by the government agencies in both rural and urban areas. PMID:24977099

Social and Physical Environments and Self-Rated Health in Urban and Rural Communities in Korea

PubMed Central

Lee, Jung-A; Park, Jong Heon; Kim, Myung

2015-01-01

This study evaluated the associations between social and physical environments and self-rated health (SRH) for urban and rural Korean adults, using data from the Korean Community Health Survey (KCHS) of 199,790 participants (115,454 urban and 84,336 rural). The main dependent variable was SRH, while the primary independent variables were social and physical characteristics. Urban residents reported better SRH than did rural residents. Five social environmental variables (trust of neighbors, residence in the area for over 20 years, exchanging help with neighbors, friend and fellowship activities, contact with relatives and neighbors over five times per month) were more prevalent among rural residents. Satisfaction with physical environment was more common among rural residents, but satisfaction with traffic and healthcare facilities was more common among urban areas. After adjusting for relevant factors, positive associations between SRH and trust of neighbors, exchanging help with neighbors, participation in social activities or organizations, and physical environment existed in both rural and urban populations. Also, in both areas, there was no demonstrated association between SRH and years of residence or frequency of contact with relatives. Our findings suggest the existence of an association between social and physical factors and perceived health status among the general population of Korea. PMID:26569279

Meanings and expressions of care and caring for elders in urban Namibian families: a transcultural nursing study.

PubMed

Leuning, C J; Small, L F; van Dyk, A

2000-09-01

Since Namibia's Independence in 1990, the population of elders--persons 65 years old and older--in urban communities is growing steadily. As such, requests for home health care, health counselling, respite care and residential care for aging members of society are overwhelming nurses and the health care system. This study expands transcultural nursing knowledge by increasing understanding of generic (home-based) patterns of elder care that are practised and lived by urban Namibian families. Guided by Madeleine Leininger's theory of culture care diversity and universality and the ethnonursing research method, emic (insider) meanings and expressions of care and caring for elders in selected urban households have been transposed into five substantive themes. The themes, which depict what carring for elders means to urban families, include: 1 nurturing the health of the family, 2 trusting in the benevolence of life as lived, 3 honouring one's elders, 4 sustaining security and purpose for life amid uncertainty, and 5 living with rapidly changing cultural and social structures. These findings add a voice from the developing world to the evolving body of transcultural nursing knowledge. Synthesis of findings with professional care practices facilitates the creation of community-focussed models for provisioning culturally congruent nursing care to elders and their families in urban Namibia.

Barriers to prostate cancer prevention and community recommended health education strategies in an urban African American community in Jackson, Mississippi.

PubMed

Ekúndayò, Olúgbémiga T; Tataw, David B

2013-01-01

This article describes the use of survey research in collaboration with the African American urban community of Georgetown, Jackson, Mississippi to identify and understand prostate cancer knowledge, resource utilization, and health education strategies considered most effective in reaching the community with prostate cancer prevention messages. The study revealed profound needs in disease identification and resources awareness and utilization. Barriers to utilization were identified by participants to include lack of self-efficacy, low self-esteem, lack of trust in the health care system, limited knowledge of prostate pathology, and limited ability to pay. Participants' recommended strategies for reaching the community with prostate cancer education include traditional and nontraditional strategies. The list of recommendations exclude modern-day outlets such as handheld devices, Twitter, Facebook, blogs, wikis, and other Internet-based outlets. The findings provide a road map for program development and an intervention research agenda custom-tailored to the Georgetown community of Jackson, Mississippi.

Urban-Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs.

PubMed

Onyeonoro, Ugochukwu U; Ogah, Okechukwu S; Ukegbu, Andrew U; Chukwuonye, Innocent I; Madukwe, Okechukwu O; Moses, Akhimiem O

2016-01-01

Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Data were collected using the modified World Health Organization's STEPS questionnaire, including data on care seeking following the onset of illness. Descriptive statistics and logistic regressions were used to analyze care-seeking behavior and to identify differences among those seeking care in urban and rural areas. In both urban and rural areas, patent medicine vendors (73.0%) were the most common sources of primary care following the onset of illness, while only 20.0% of the participants used formal care. Significant predictors of difference in care-seeking practices between residents in urban and rural communities were educational status, income, occupation, and body mass index. Efforts should be made to reduce barriers to formal health-care service utilization in the state by increasing health insurance coverage, strengthening the health-care system, and increasing the role of patent medicine vendors in the formal health-care delivery system.

The Role Of Nonprofit Hospitals In Identifying And Addressing Health Inequities In Cities.

PubMed

Carroll-Scott, Amy; Henson, Rosie Mae; Kolker, Jennifer; Purtle, Jonathan

2017-06-01

For nonprofit hospitals to maintain their tax-exempt status, the Affordable Care Act requires them to conduct a community health needs assessment, in which they evaluate the health needs of the community they serve, and to create an implementation strategy, in which they propose ways to address these needs. We explored the extent to which nonprofit urban hospitals identified equity among the health needs of their communities and proposed health equity strategies to address this need. We conducted a content analysis of publicly available community health needs assessments and implementation strategies from 179 hospitals in twenty-eight US cities in the period August-December 2016. All of the needs assessments included at least one implicit health equity term (such as disparities , disadvantage , poor , or minorities ), while 65 percent included at least one explicit health equity term ( equity , health equity , inequity , or health inequity ). Thirty-five percent of implementation strategies included one or more explicit health equity terms, but only 9 percent included an explicit activity to promote health equity. While needs assessment reporting requirements have the potential to encourage urban nonprofit hospitals to address health inequities in their communities, hospitals need incentives and additional capacity to invest in strategies that address the underlying structural social and economic conditions that cause health inequities. Project HOPE—The People-to-People Health Foundation, Inc.

Bringing urban governance back in: Neighborhood conflicts and depression.

PubMed

Fu, Qiang

2018-01-01

Urban governance and its impact on contentious politics have received remarkably little attention in existing studies on mental health. Drawing on a measure of neighborhood conflicts developed in a survey of thirty-nine urban neighborhoods in Guangzhou, China, this article investigates the potential link between urban governance and mental health. Net of sociodemographic, relational, and environmental measures, it finds that among residents' conflicts with different entities of urban governance, only those with local/grassroots governments are significantly associated with more depressive symptoms. Moreover, these subgroups of government-oriented conflicts associated with more depressive symptoms are related to neighborhood planning and communal properties, reflecting a dilemma in the Chinese model of urban governance. By offering a relational interpretation of neighborhood conflicts, this study not only challenges the previous view that community building in China improves mental health, but calls attention to the significance of urban governance in research on mental health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Desired mental health resources for urban, ethnically diverse, impoverished women struggling with anxiety and depression.

PubMed

Doornbos, Mary Molewyk; Zandee, Gail Landheer; DeGroot, Joleen; Warpinski, Mary

2013-01-01

Depression and anxiety are mental health issues that disproportionately affect women-particularly when access to culturally sensitive care is limited. The purpose of this study was to identify mental health concerns in three urban, ethnically diverse, underserved, and impoverished neighborhoods using the ideological perspective of community-based participatory research. In the context of long-term partnerships between a department of nursing and these neighborhoods, we recruited 61 women aged 18 to 69 years and collected data via homogeneous focus groups comprised of Black, Hispanic, and White women, respectively. We conducted five of the focus groups in English and one in Spanish. The women perceived anxiety and depression as significant concerns for themselves, their families, and their communities. They used unique community resources to manage mental health issues and desired new resources, including support groups and education.

The Relationships Between Depressive Symptoms, Functional Health Status, Physical Activity, and the Availability of Recreational Facilities: a Rural-Urban Comparison in Middle-Aged and Older Chinese Adults.

PubMed

Deng, Yazhuo; Paul, David R

2018-06-01

This study drew upon the ecological system theory to demonstrate rural-urban differences in the relationships between the availability of recreational facilities, physical activity (PA), functional health status, and depressive symptoms in middle-aged and older Chinese adults. Nationally representative data (n = 5949) from the Chinese Health and Retirement Longitudinal Study (CHARLS, 2011-2013) were examined using the multigroup structural equation modeling approach. The results suggest that higher availability of recreational facilities in the urban communities was associated with higher levels of leisure time physical activity (LTPA), better functional capacity, and less occurrence of depressive symptoms among urban participants. In contrast, LTPA engagement among rural participants was low and had negligible mitigating effects on functional decline and depressive symptoms. The findings also show that functional health status mediated the association between total PA and depressive symptoms in both rural and urban participants. However, high levels of total PA were directly associated with elevated depressive symptoms, suggesting that the context of PA and related socioeconomic factors might explain this association after the non-LTPA components were included. The findings highlight how complex patterns of intrapersonal, behavioral, and environmental correlates influence depressive symptoms in middle-aged and older Chinese adults. The context of PA should be considered when creating targeted strategies to prevent depressive symptoms. As an inactive lifestyle evolves with China's rapid urbanization, joint efforts from public health and urban planning should be made to promote LTPA and develop active living communities for achieving optimal health in later life.

The oral health behaviours and fluid consumption practices of young urban Aboriginal preschool children in south-western Sydney, New South Wales, Australia.

PubMed

George, Ajesh; Grace, Rebekah; Elcombe, Emma; Villarosa, Amy R; Mack, Holly A; Kemp, Lynn; Ajwani, Shilpi; Wright, Darryl C; Anderson, Cheryl; Bucknall, Natasha; Comino, Elizabeth

2018-04-01

Australian Aboriginal children have a higher risk of dental caries yet there is limited focus on oral health risk factors for urban Aboriginal preschool children. This study examined the oral health behaviours and fluid consumption practices of young children from an urban Aboriginal community in south-western Sydney, Australia. In total, 157 Aboriginal children who were recruited to the "Gudaga" longitudinal birth cohort participated in this study. A survey design was employed and parents responded to the oral health questions when their child was between 18 and 60 months. Few parents (20%) were concerned about their child's oral health across the time period. By 60 months, only 20% of children had seen a dentist while 80% were brushing their teeth at least once daily. High levels of bottle use were seen up to 30 months. Consumption of sugary drinks was also very high in the early years, although this was replaced by water by 36 months. While there are some encouraging findings, such as the rates of tooth brushing and increasing rates of water consumption, the findings do highlight the poor uptake of dental services and high levels of bottle usage among urban aboriginal children during their early years. SO WHAT?: Targeted oral health promotional programs are needed in the urban Aboriginal community to better support parents understanding of good oral health practices in the early years and engagement with dental health services. © 2017 Australian Health Promotion Association.

'We usually just start dancing our Indian dances': urban American Indian (AI) female youths' negotiation of identity, health and the body.

PubMed

Jette, Shannon; Roberts, Erica Blue

2016-03-01

In this article, we utilise qualitative research techniques to explore how 14 urban American Indian (AI) females (aged 11-17) living in the state of Maryland discursively construct and experience health and the body, as well as how/if traditional culture shapes their understandings. In doing so, we address a significant gap in the knowledge base concerning the health beliefs of urban AI youth, and build upon research utilising a decolonising approach. Using a two-step process of thematic analysis and poststructuralist discourse analysis, we arrived at three key findings: (1) while youths are taught (and learn) mainstream lessons about health and bodily norms (mostly at school), they negotiate these lessons in complex and at times contradictory ways; (2) they do not view their AI status as conferring more or less risk upon them or their community; and (3) AI identity appears to be fluid in nature, becoming more salient, even a resource, in certain situations. We conclude with a discussion of the importance of spaces within the urban context in shaping youths' embodied subjectivities, and in particular, contrast the space of the school with that of the urban AI community centre. © 2015 Foundation for the Sociology of Health & Illness.

From front yards to street corners: revitalizing neighborhoods through community-based land stewardship

Treesearch

Colleen Murphy-Dunning

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research.

PubMed

Ceasar, Joniqua; Peters-Lawrence, Marlene H; Mitchell, Valerie; Powell-Wiley, Tiffany M

2017-11-21

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB), which influenced the study's design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities.

Influence of newborn health messages on care-seeking practices and community health behaviors among participants in the Zambia Chlorhexidine Application Trial.

PubMed

Sivalogan, Kasthuri; Semrau, Katherine E A; Ashigbie, Paul G; Mwangi, Sheila; Herlihy, Julie M; Yeboah-Antwi, Kojo; Banda, Bowen; Grogan, Caroline; Biemba, Godfrey; Hamer, Davidson H

2018-01-01

Identifying and understanding traditional perceptions that influence newborn care practices and care-seeking behavior are crucial to developing sustainable interventions to improve neonatal health. The Zambia Chlorhexidine Application Trial (ZamCAT), a large-scale cluster randomized trial, assessed the impact of 4% chlorhexidine on neonatal mortality and omphalitis in Southern Province, Zambia. The main purpose of this post-ZamCAT qualitative study was to understand the impact of newborn care health messages on care-seeking behavior for neonates and the acceptability, knowledge, and attitudes towards chlorhexidine cord care among community members and health workers in Southern Province. Five focus group discussions and twenty-six in-depth interviews were conducted with mothers and health workers from ten health centers (5 rural and 5 peri-urban/urban). Community perceptions and local realities were identified as fundamental to care-seeking decisions and influenced individual participation in particular health-seeking behaviors. ZamCAT field monitors (data collectors) disseminated health messages at the time of recruitment at the health center and during subsequent home visits. Mothers noted that ZamCAT field monitors were effective in providing lessons and education on newborn care practices and participating mothers were able to share these messages with others in their communities. Although the study found no effect of chlorhexidine cord washes on neonatal mortality, community members had positive views towards chlorhexidine as they perceived that it reduced umbilical cord infections and was a beneficial alternative to traditional cord applications. The acceptability of health initiatives, such as chlorhexidine cord application, in community settings, is dependent on community education, understanding, and engagement. Community-based approaches, such as using community-based cadres of health workers to strengthen referrals, are an acceptable and potentially effective strategy to improve care-seeking behaviors and practices.

Mobile Technology for Empowering Health Workers in Underserved Communities: New Approaches to Facilitate the Elimination of Neglected Tropical Diseases.

PubMed

Stanton, Michelle; Molineux, Andrew; Mackenzie, Charles; Kelly-Hope, Louise

2016-01-01

As global mobile phone penetration increases, direct health information communication from hard-to-reach communities is becoming commonplace. Mobile health (mHealth) tools that enable disease control programs to benefit from this information, while simultaneously empowering community members to take control of their own health, are vital to the goal of universal health care. Our aim was to highlight the development of the Liverpool mHealth Suite (LMS), which has been designed to address this need and improve health services for neglected tropical diseases being targeted for global elimination, such as lymphatic filariasis. The LMS has two main communication approaches-short message service and mobile phone apps-to facilitate real-time mass drug administration (MDA) coverage, reporting patient numbers, managing stock levels of treatment supplies, and exchanging health information to improve the quality of care of those affected. The LMS includes the MeasureSMS-MDA tool to improve drug supplies and MDA coverage rates in real-time (currently being trialed in urban Tanzania); the MeasureSMS-Morbidity tool to map morbidity, including lymphedema and hydrocele cases (initially piloted in rural Malawi and Ghana, then extended to Ethiopia, and scaled up to large urban areas in Bangladesh and Tanzania); the LyMSS-lymphedema management supply system app to improve distribution of treatments (trialed for 6 months in Malawi with positive impacts on health workers and patients); and the HealthFront app to improve education and training (in development with field trials planned). The current success and scale-up of the LMS by many community health workers in rural and urban settings across Africa and Asia highlights the value of this simple and practical suite of tools that empowers local health care workers to contribute to local, national, and global elimination of disease.

Sexual orientation disclosure to health care providers among urban and non-urban southern lesbians.

PubMed

Austin, Erika Laine

2013-01-01

Concerns regarding sexual orientation disclosure to health care providers have been suggested as a barrier to care which may account for documented differences in the health care utilization of lesbians relative to heterosexual women. This study explored the correlates of sexual orientation disclosure to health care providers among 934 lesbian women living in urban and non-urban areas of the South. Psychosocial resources, such as self-esteem, social support, and mastery, along with several lesbian-specific experiences (proportion of lesbian, gay, bisexual, or transgender friends, access to the lesbian, gay, bisexual, or transgender community, degree of being "out"), were all independently associated with greater likelihood of having disclosed to a health care provider. Internalized homophobia and lesbian-related stigma decreased the likelihood of disclosure. Lesbians living in non-urban areas were significantly less likely to have disclosed than women in urban areas, suggesting that disclosure may present a special concern for populations in non-urban areas.

Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study

PubMed Central

Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

2015-01-01

Objectives To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. Design Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. Setting Urban disadvantaged communities in the East Midlands of the UK. Participants 45 respondents, including 34 people of South Asian origin (16 at-risk individuals, six family groups involving 18 relatives), of mainly Pakistani and Indian origin, including 16 non-English speakers; and 11 health professionals working locally with communities of concern. Results South Asian participants underlined the challenges of requiring family members across generations to engage in modifying dietary behaviours, and the central role of communal eating of traditional ‘Asian’ food in their cultural lives. Barriers to increasing physical activity included cost, personal safety and lack of time outside of long working hours and carer commitments. However, increasing walking activity was regarded as feasible by both community and health professional participants. Respondents emphasised using a social approach for potential interventions, undertaking activity with family or friends and with bilingual community peers to facilitate engagement, motivation and support. Spoken content and delivery of interventions was favoured, including personal stories and multilingual audio–visual information; within local informal rather than provider settings, including the home; and aided by pedometers for self-monitoring. Conclusions Focusing on physical activity by increasing walking may hold promise as health promotion in this deprived South Asian community context. Further intervention development, with exploration of feasibility and acceptability of the social approach and elements suggested, is merited. PMID:25724983

Arsenic, cadmium, lead, and mercury in surface soils, Pueblo, Colorado: Implications for population health risk

USGS Publications Warehouse

Diawara, D.M.; Litt, J.S.; Unis, D.; Alfonso, N.; Martinez, L.A.; Crock, J.G.; Smith, D.B.; Carsella, J.

2006-01-01

Decades of intensive industrial and agricultural practices as well as rapid urbanization have left communities like Pueblo, Colorado facing potential health threats from pollution of its soils, air, water and food supply. To address such concerns about environmental contamination, we conducted an urban geochemical study of the city of Pueblo to offer insights into the potential chemical hazards in soil and inform priorities for future health studies and population interventions aimed at reducing exposures to inorganic substances. The current study characterizes the environmental landscape of Pueblo in terms of heavy metals, and relates this to population distributions. Soil was sampled within the city along transects and analyzed for arsenic (As), cadmium (Cd), mercury (Hg) and lead (Pb). We also profiled Pueblo's communities in terms of their socioeconomic status and demographics. ArcGIS 9.0 was used to perform exploratory spatial data analysis and generate community profiles and prediction maps. The topsoil in Pueblo contains more As, Cd, Hg and Pb than national soil averages, although average Hg content in Pueblo was within reported baseline ranges. The highest levels of As concentrations ranged between 56.6 and 66.5 ppm. Lead concentrations exceeded 300 ppm in several of Pueblo's residential communities. Elevated levels of lead are concentrated in low-income Hispanic and African-American communities. Areas of excessively high Cd concentration exist around Pueblo, including low income and minority communities, raising additional health and environmental justice concerns. Although the distribution patterns vary by element and may reflect both industrial and non-industrial sources, the study confirms that there is environmental contamination around Pueblo and underscores the need for a comprehensive public health approach to address environmental threats in urban communities. ?? Springer 2006.

Urban farming activity towards sustainable wellbeing of urban dwellers

NASA Astrophysics Data System (ADS)

Othman, N.; Mohamad, M.; Latip, R. A.; Ariffin, M. H.

2018-02-01

In Malaysia, urban farming is viewed as a catalyst towards achieving the well-being of urban dwellers and natural environment. Urban farming is a strategy for Malaysia’s food and economic security, and as one of the foci in the agriculture transformation whereby urban dwellers are encouraged to participate in this activity. Previous study proved that urban farming can help to address social problems of food security, urban poverty and high living cost, also provides leisure and recreation among urban dwellers. Thus, this study investigates the best urban farming practices suitable for urban setting, environment and culture of urban dwellers. Data collection was done via questionnaire survey to urban farmers of a selected community garden in Subang Jaya, Selangor. Meanwhile, on-site observations were carried out on gardening activities and the gardens’ physical attributes. The study sample encompasses of 131 urban farmers of 22 community gardens in Subang Jaya. It was found that most of the community gardens practiced crops planting on the ground or soil base planting and dwellers in the lower income group with monthly low household income constitutes the majority (83.2%) of the respondents. Social and health benefits are the highest motivating factors for urban farmers. This study provides unprecedented insights on urban farming practices and motivations in a Malaysian setting.

Mental health and poverty in the inner city.

PubMed

Anakwenze, Ujunwa; Zuberi, Daniyal

2013-08-01

Rapid urbanization globally threatens to increase the risk to mental health and requires a rethinking of the relationship between urban poverty and mental health. The aim of this article is to reveal the cyclic nature of this relationship: Concentrated urban poverty cultivates mental illness, while the resulting mental illness reinforces poverty. The authors used theories about social disorganization and crime to explore the mechanisms through which the urban environment can contribute to mental health problems. They present some data on crime, substance abuse, and social control to support their claim that mental illness reinforces poverty. The authors argue that, to interrupt this cycle and improve outcomes, social workers and policymakers must work together to implement a comprehensive mental health care system that emphasizes prevention, reaches young people, crosses traditional health care provision boundaries, and involves the entire community to break this cycle and improve the outcomes of those living in urban poverty.

Can't Have One without the Other: Mental Health Providers and Community Parents Reducing Barriers to Services for Families in Urban Poverty

ERIC Educational Resources Information Center

Frazier, Stacy L.; Abdul-Adil, Jaleel; Atkins, Marc S.; Gathright, Tamara; Jackson, Maudette

2007-01-01

University-community partnerships are widely recognized as critical to the success of community research and advocacy work but difficult to form and sustain. This article will describe a unique facet of that partnership, namely the collaboration between mental health clinicians and community consultants, a partnership that our data suggest was a…

Child health security in China: a survey of child health insurance coverage in diverse areas of the country.

PubMed

Xiong, Juyang; Hipgrave, David; Myklebust, Karoline; Guo, Sufang; Scherpbier, Robert W; Tong, Xuetao; Yao, Lan; Moran, Andrew E

2013-11-01

China embarked on an ambitious health system reform in 2009, and pledged to achieve universal health insurance coverage by 2020. However, there are gaps in access to healthcare for some children in China. We assessed health insurance status and associated variables among children under five in twelve communities in 2010: two urban community health centers and two rural township health centers in each of three municipalities located in China's distinctly different East, Central and Western regions. Information on demographic and socio-economic variables and children's insurance status was gathered from parents or caregivers of all children enrolled in local health programs, and others recruited from the local communities. Only 62% of 1131 children assessed were insured. This figure did not vary across geographic regions, but urban children were less likely to be insured than rural children. In multivariate analysis, infants were 2.44 times more likely to be uninsured than older children and children having at least one migrant parent were 1.90 times more likely to be uninsured than those living with non-migrant parents. Low maternal education was also associated with being uninsured. Gaps in China's child health insurance coverage might be bridged if newborns are automatically covered from birth, and if insurance is extended to all urban migrant children, regardless of the family's residential registration status and size. Copyright © 2013 Elsevier Ltd. All rights reserved.

The Heart of the Mission

ERIC Educational Resources Information Center

Forest, Angela

2008-01-01

This article discusses the Urban Health Program, a University of Illinois at Chicago program that seeks to improve the quality of medical care in communities of color. The UIC program began in 1968 to attract and train minority medical students. In 1978, the Illinois Legislature expanded the program, renaming it the Urban Health Program (UHP), in…

The Brookline Early Education Project: a 25-year follow-up study of a family-centered early health and development intervention.

PubMed

Palfrey, Judith S; Hauser-Cram, Penny; Bronson, Martha B; Warfield, Marji Erickson; Sirin, Selcuk; Chan, Eugenia

2005-07-01

Clinicians, scientists, and policy makers are increasingly taking interest in the long-term outcomes of early intervention programs undertaken during the 1960s and 1970s, which were intended to improve young children's health and educational prospects. The Brookline Early Education Project (BEEP) was an innovative, community-based program that provided health and developmental services for children and their families from 3 months before birth until entry into kindergarten. It was open to all families in the town of Brookline and to families from neighboring Boston, to include a mixture of families from suburban and urban communities. The goal of the project, which was administered by the Brookline Public Schools, was to ensure that children would enter kindergarten healthy and ready to learn. Outcome studies of BEEP and comparison children during kindergarten and second grade demonstrated the program's effectiveness during the early school years. The goal of this follow-up study was to test the hypotheses that BEEP participants, in comparison with their peers, would have higher levels of educational attainment, higher incomes, and more positive health behaviors, mental health, and health efficacy during the young adult period. Participants were young adults who were enrolled in the BEEP project from 1973 to 1978. Comparison subjects were young adults in Boston and Brookline who did not participate in BEEP but were matched to the BEEP group with respect to age, ethnicity, mother's educational level, and neighborhood (during youth). A total of 169 children were enrolled originally in BEEP and monitored through second grade. The follow-up sample included a total of 120 young adults who had participated in BEEP as children. The sample differed from the original BEEP sample in having a slightly larger proportion of college-educated mothers and a slightly smaller proportion of urban families but otherwise resembled the original BEEP sample. The demographic features of the BEEP and comparison samples were similar. The young adults were asked to complete a survey that focused on the major domains of educational/functional outcomes and health/well-being. The study used a quasi-experimental causal-comparative design involving quantitative analyses of differences between the BEEP program and comparison groups, stratified according to community. Hypotheses were tested with analysis of variance and multivariate analysis of variance techniques. Analyses of the hypotheses included the main effects of group (BEEP versus comparison sample) and community (suburban versus urban location), as well as their interaction. Young adults from the suburban community had higher levels of educational attainment than did those in the urban group, with little difference between the suburban BEEP and comparison groups. In the urban group, participation in the BEEP program was associated with completing >1 additional year of schooling. Fewer BEEP young adults reported having a low income (less than 20000 dollars); the income differences were accounted for largely by the urban participants. The percentage of subjects with private health insurance was significantly lower in the urban group overall, but the BEEP urban group had higher rates of private insurance than did the comparison group. More than 80% of both suburban samples reported being in very good or excellent health; the 2 urban groups had significantly lower ratings, with 64% of the BEEP group and only 41.67% of the comparison group reaching this standard. Overall, suburban participants reported more positive health behaviors, more perceived competence, and less depression. Among the urban samples, however, participation in BEEP was associated with higher levels of health efficacy, more positive health behaviors, and less depression than their peers. No previous study has focused as extensively on health-related outcomes of early education programs. BEEP participants living in urban communities had advantages over their peers in educational attainment, income, health, and well-being. The educational advantages found for BEEP participants in the early years of schooling included executive skills such as planning, organizing, and completing school-related tasks. It is likely that these early advantages in executive function extended beyond education-related tasks to other activities as participants became responsible for their own lives. The long-term benefits revealed in this study are consistent with the findings of previous long-term studies that indicated that participants in high-quality intervention programs are less likely to cost taxpayers money for health, educational, and public assistance services. The BEEP program appears to have somewhat blunted differences between the urban and suburban groups. The results of this study add to the growing body of findings that indicate that long-term benefits occur as the result of well-designed, intensive, comprehensive early education. The health benefits add a unique and important extension to the findings of other studies.

Newborn Care Practices among Mother-Infant Dyads in Urban Uganda

PubMed Central

Kayom, Violet Okaba; Kakuru, Abel; Kiguli, Sarah

2015-01-01

Background. Most information on newborn care practices in Uganda is from rural communities which may not be generalized to urban settings. Methods. A community based cross-sectional descriptive study was conducted in the capital city of Uganda from February to May 2012. Quantitative and qualitative data on the newborn care practices of eligible mothers were collected. Results. Over 99% of the mothers attended antenatal care at least once and the majority delivered in a health facility. Over 50% of the mothers applied various substances to the cord of their babies to quicken the healing. Although most of the mothers did not bathe their babies within the first 24 hours of birth, the majority had no knowledge of skin to skin care as a thermoprotective method. The practice of bathing babies in herbal medicine was common (65%). Most of the mothers breastfed exclusively (93.2%) but only 60.7% initiated breastfeeding within the first hour of life, while a significant number (29%) used prelacteal feeds. Conclusion. The inadequate newborn care practices in this urban community point to the need to intensify the promotion of universal coverage of the newborn care practices irrespective of rural or urban communities and irrespective of health care seeking indicators. PMID:26713096

Checklist for healthy and sustainable communities.

PubMed

Capon, Anthony G; Blakely, Edward J

2007-01-01

This paper describes a 10-point checklist for the planning and development of healthy and sustainable communities. The 10 domains in the checklist are essentially physical characteristics of places. Each domain has relevance to the health of people living in the place, and to the sustainability of the environment. The checklist is intended as a tool for those who plan, develop and manage urban environments. Such tools can be valuable for assessing the health and environmental impacts of decisions made by urban and transport planners, and businesses engaged in land development and infrastructure projects.

Baseline Results of the First Healthy Schools Evaluation among a Community of Young, Irish, Urban Disadvantaged Children and a Comparison of Outcomes with International Norms

ERIC Educational Resources Information Center

Comiskey, Catherine M.; O'Sullivan, Karin; Quirke, Mary B.; Wynne, Ciara; Hollywood, Eleanor; MGillloway, Sinead

2012-01-01

Background: In 2008, the Irish Government initiated a pilot Healthy Schools Programme based on the World Health Organization Health Promoting Schools Model among children attending schools officially designated as urban and disadvantaged. We present here the first results on physical and emotional health and the relationship between childhood…

The roles of community health workers in management of non-communicable diseases in an urban township

PubMed Central

Puoane, Thandi; Schneider, Helen; Levitt, Naomi S.; Steyn, Krisela

2014-01-01

Background Community health workers (CHWs) are increasingly being recognised as a crucial part of the health workforce in South Africa and other parts of the world. CHWs have taken on a variety of roles, including community empowerment, provision of services and linking communities with health facilities. Their roles are better understood in the areas of maternal and child health and infectious diseases (HIV infection, malaria and tuberculosis). Aim This study seeks to explore the current roles of CHWs working with non-communicable diseases (NCDs). Setting The study was conducted in an urban township in Cape Town, South Africa. Method A qualitative naturalistic research design utilising observations and in-depth interviews with CHWs and their supervisors working in Khayelitsha was used. Results CHWs have multiple roles in the care of NCDs. They act as health educators, advisors, rehabilitation workers and support group facilitators. They further screen for complications of illness and assist community members to navigate the health system. These roles are shaped both by expectations of the health system and in response to community needs. Conclusion This study indicates the complexities of the roles of CHWs working with NCDs. Understanding the actual roles of CHWs provides insights into not only the competencies required to enable them to fulfil their daily functions, but also the type of training required to fill the present gaps. PMID:26245419

Reforming Victoria's primary health and community service sector: rural implications.

PubMed

Alford, K

2000-01-01

In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.

A socio-psychological perspective on community participation in health during the Unidad Popular government: Santiago de Chile, from 1970 to 1973.

PubMed

Hadjez-Berrios, Esteban

2014-01-01

Community participation in health has conventionally been described and analysed from a non-historical perspective, neglecting the central role that disadvantaged communities have played in the construction of health institutions in our societies, alienating collective health from its historical subject. From a socio-psychological perspective, this study explores the experiences of community participation in health during the Unidad Popular government in Santiago de Chile from 1970 to 1973, evidencing a radical pedagogical process inside poor urban settlements, aimed to transform Chilean classist health institutions. These findings contribute to a critical understanding of community participation in health, conceived as a dialectic and transformative action.

Multilevel Effects of Wealth on Women's Contraceptive Use in Mozambique

PubMed Central

Dias, José G.; de Oliveira, Isabel Tiago

2015-01-01

Objective This paper analyzes the impact of wealth on the use of contraception in Mozambique unmixing the contextual effects due to community wealth from the individual effects associated with the women's situation within the community of residence. Methods Data from the 2011 Mozambican Demographic and Health Survey on women who are married or living together are analyzed for the entire country and also for the rural and urban areas separately. We used single level and multilevel probit regression models. Findings A single level probit regression reveals that region, religion, age, previous fertility, education, and wealth impact contraceptive behavior. The multilevel analysis shows that average community wealth and the women’s relative socioeconomic position within the community have significant positive effects on the use of modern contraceptives. The multilevel framework proved to be necessary in rural settings but not relevant in urban areas. Moreover, the contextual effects due to community wealth are greater in rural than in urban areas and this feature is associated with the higher socioeconomic heterogeneity within the richest communities. Conclusion This analysis highlights the need for the studies on contraceptive behavior to specifically address the individual and contextual effects arising from the poverty-wealth dimension in rural and urban areas separately. The inclusion in a particular community of residence is not relevant in urban areas, but it is an important feature in rural areas. Although the women's individual position within the community of residence has a similar effect on contraceptive adoption in rural and urban settings, the impact of community wealth is greater in rural areas and smaller in urban areas. PMID:25786228

Women's Perceptions of Reproductive Health in Three Communities around Beirut, Lebanon

PubMed Central

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2006-01-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities. A 2005 Reproductive Health Matters. All rights reserved. PMID:16035595

Health problems and associated risk factors in selected urban and rural elderly population groups of South-West Nigeria.

PubMed

Abegunde, Kayode A; Owoaje, Eme T

2013-01-01

The increasing number of the elderly persons and their attendant health problems has implications on public health programs in developing countries. However, there is limited information on the elderly residing outside major cities in Nigeria. Therefore, this study was conducted to determine and compare prevalent health problems and associated risk factors in the elderly of urban and rural communities in Oyo State, Nigeria. A comparative cross-sectional survey of consenting adults aged 60 years and above in Iseyin (urban) and Ilua (rural) communities of Oyo State in south-west, Nigeria. Using cluster sampling technique, a total of 630 respondents; 316 in the urban and 314 in the rural participated. Information was sought on the respondents' socio-demographic characteristics, life style, self-reported health problems. Anthropometric measurements and clinical examination including blood pressure measurements and visual acuity were conducted. The mean age of urban respondents was 72.2 ± 9.5 years compared with 70.8 ± 8.1 years in the rural. There were more females (61.1%) than males (38.9%) in both the locations. Self-reported health problems in both locations were similar and included reduced sexual fulfillment, musculoskeletal problems such as muscular and low back pain. On clinical examination, the main health problems were visual impairment 58.7% in the urban versus 41.7% in the rural ( P < 0.001). Prevalence of hypertension among urban and rural respondents was 38.3% and 34.7%, respectively ( P = 0.35). Osteoarthritis was significantly higher 8.5% in urban than 3.2% obtained in rural ( P = 0.004v). On multivariate analysis, female gender, increasing body mass index, and low monthly income were significant predictors of hypertension in both locations. Cardiovascular, musculoskeletal, and visual noncommunicable diseases were prevalent in both elderly populations. Social conditions and gender play important role in the health status of the elderly.

Ecological health in the Nation's streams

USGS Publications Warehouse

Carlisle, Daren M.; Woodside, Michael D.

2013-01-01

Aquatic biological communities, which are collections of organisms, are a direct measure of stream health because they indicate the ability of a stream to support life. This fact sheet highlights selected findings of a national assessment of stream health by the National Water-Quality Assessment (NAWQA) Program of the U.S. Geological Survey (USGS). The assessment was unique in that it integrated the condition of three biological communities—algae, macroinvertebrates, and fish—as well as measures of streamflow modification, pesticides, nutrients, and other factors. At least one biological community was altered at 83 percent of assessed streams, and the occurrence of altered communities was highest in urban streams. Streamflows were modified at 86 percent of assessed streams, and increasing severity of streamflow modification was associated with increased occurrence of altered biological communities. Agricultural and urban land use in watersheds may contribute pesticides and nutrients to stream waters, and increasing concentrations of these chemicals were associated with increased occurrence of altered biological communities.

Development of a replicable process for translating science into practical health education messages.

PubMed

Tyus, Nadra C; Freeman, Randall J; Gibbons, M Christopher

2006-09-01

There has been considerable discussion about translating science into practical messages, especially among urban minority and "hard-to-reach" populations. Unfortunately, many research findings rarely make it back in useful format to the general public. Few innovative techniques have been established that provide researchers with a systematic process for developing health awareness and prevention messages for priority populations. The purpose of this paper is to describe the early development and experience of a unique community-based participatory process used to develop health promotion messages for a predominantly low-income, black and African-American community in Baltimore, MD. Scientific research findings from peer-reviewed literature were identified by academic researchers. Researchers then taught the science to graphic design students and faculty. The graphic design students and faculty then worked with both community residents and researchers to transform this information into evidence-based public health education messages. The final products were culturally and educationally appropriate, health promotion messages reflecting urban imagery that were eagerly desired by the community. This early outcome is in contrast to many previously developed messages and materials created through processes with limited community involvement and by individuals with limited practical knowledge of local community culture or expertise in marketing or mass communication. This process may potentially be utilized as a community-based participatory approach to enhance the translation of scientific research into desirable and appropriate health education messages.

Spatial variation in the parasite communities and genomic structure of urban rats in New York City.

PubMed

Angley, L P; Combs, M; Firth, C; Frye, M J; Lipkin, I; Richardson, J L; Munshi-South, J

2018-02-01

Brown rats (Rattus norvegicus) are a globally distributed pest. Urban habitats can support large infestations of rats, posing a potential risk to public health from the parasites and pathogens they carry. Despite the potential influence of rodent-borne zoonotic diseases on human health, it is unclear how urban habitats affect the structure and transmission dynamics of ectoparasite and microbial communities (all referred to as "parasites" hereafter) among rat colonies. In this study, we use ecological data on parasites and genomic sequencing of their rat hosts to examine associations between spatial proximity, genetic relatedness and the parasite communities associated with 133 rats at five sites in sections of New York City with persistent rat infestations. We build on previous work showing that rats in New York carry a wide variety of parasites and report that these communities differ significantly among sites, even across small geographical distances. Ectoparasite community similarity was positively associated with geographical proximity; however, there was no general association between distance and microbial communities of rats. Sites with greater overall parasite diversity also had rats with greater infection levels and parasite species richness. Parasite community similarity among sites was not linked to genetic relatedness of rats, suggesting that these communities are not associated with genetic similarity among host individuals or host dispersal among sites. Discriminant analysis identified site-specific associations of several parasite species, suggesting that the presence of some species within parasite communities may allow researchers to determine the sites of origin for newly sampled rats. The results of our study help clarify the roles that colony structure and geographical proximity play in determining the ecology of R. norvegicus as a significant urban reservoir of zoonotic diseases. Our study also highlights the spatial variation present in urban rat parasite communities, indicating that rats across New York City are not reservoirs for a homogenous set of parasites and pathogens. As a result, the epidemiological risks may be similarly heterogeneous for people in urban habitats. © 2017 Blackwell Verlag GmbH.

Women's perceptions of reproductive health in three communities around Beirut, Lebanon.

PubMed

Kaddour, Afamia; Hafez, Raghda; Zurayk, Huda

2005-05-01

The aim of this study was to elicit definitions of the concept of reproductive health among women in three communities around Beirut, Lebanon, as part of the reproductive health component of a larger Urban Health Study. The communities were characterised by poverty, rural-urban mobility and heterogeneous refugee and migrant populations. A random sample of 1,869 women of reproductive age completed a questionnaire, of whom a sub-sample of 201 women were randomly selected. The women's understanding of good reproductive health included three major themes, which were expressed differently in the three communities. Their understanding included good physical and mental health, and underscored the need for activities promoting health. Their ability to reproduce and raise children, practise family planning and birth spacing, and go through pregnancy and motherhood safely were central to their reproductive duties and their social status. Finally, they saw reproductive health within the context of economic status, good marital relations and strength to cope with their lives. These findings point to the need to situate interventions in the life course of women, their health and that of their husbands and families; the importance of reproduction not only from a health services point of view, but also as regards women's roles and responsibilities within marriage and their families; and taking account of the harsh socio-economic conditions in their communities.

UNICEF Annual Report. 1985.

ERIC Educational Resources Information Center

United Nations Children's Fund, New York, NY.

UNICEF's 1984-85 program review describes ongoing child health and nutrition programs and other community-based services for children. Specific attention is given to primary health care, child survival and development, and child nutrition, as well as to safe water supplies and sanitation, formal and nonformal education, urban community-based…

Experiences and perspectives of community health workers from implementing treatment for schistosomiasis using the community directed intervention strategy in an informal settlement in Kisumu City, western Kenya.

PubMed

Odhiambo, Gladys O; Musuva, Rosemary M; Odiere, Maurice R; Mwinzi, Pauline N

2016-09-15

The Community Directed Intervention (CDI) strategy has been used to conduct various health interventions in Africa, including control of Neglected Tropical Diseases (NTDs). Although the CDI approach has shown good results in the control of onchocerciasis and lymphatic filariasis with respect to treatment coverage using community drug distributors, its utility in the control of schistosomiasis among urban poor is yet to be established. Using a longitudinal qualitative study, we explored the experiences, opportunities, challenges as well as recommendations of Community Health Workers (CHWs) after participation in annual mass drug administration (MDA) activities for schistosomiasis using the CDI approach in an urban setting. Unstructured open-ended group discussions were conducted with CHWs after completion of annual MDA activities. Narratives were obtained from CHWs using a digital audio recorder during the group discussions, transcribed verbatim and translated into English where applicable. Thematic decomposition of data was done using ATLAS.ti. software, and themes explored using the principle of interpretative phenomenological analysis (IPA). From the perspective of the CHWs, opportunities for implementing CDI in urban settings, included the presence of CHWs, their supervisory structures and their knowledge of intervention areas, and opportunity to integrate MDA with other health interventions. Several challenges were mentioned with regards to implementing MDA using the CDI strategy among them lack of incentives, fear of side effects, misconceptions regarding treatment and mistrust, difficulties working in unsanitary environmental conditions, insecurity, and insufficient time. A key recommendation in promoting more effective MDA using the CDI approach was allocation of more time to the exercise. Findings from this study support the feasibility of using CDI for implementing MDA for schistosomiasis in informal settlements of urban areas. Extensive community sensitization and provision of incentives may help address the aforementioned challenges associated with implementing MDA using the CDI strategy. Opportunities highlighted in this study may be of value to other programmes that may be considering the adoption of the CDI strategy for rolling out interventions in the urban setting.

Communities defining environmental health: examples from the Colorado (U.S.A.) Healthy Communities Initiative.

PubMed

Conner, R F; Tanjasiri, S P

2000-01-01

Communities are increasingly defining 'health' for themselves, then becoming the main actors in actions to improve their health and well being. These community members work from a broad and inclusive definition of 'health' that often incorporates environmental health as a key aspect. They also assume an ecological, or systems, viewpoint that integrates many aspects of the community that affect health and well being, including housing, health, economy, education, transportation, youth and family issues, as well as health and illness care. This paper describes a program that involves 28 large and small, urban and rural communities in the United States state of Colorado that undertook this type of community-based health improvement project. The Colorado Healthy Communities Initiative (CHCI) was designed to bring together citizens in Colorado to work collaboratively to make their communities healthier. This paper describes the program's background, including its principles, processes, and participants, then focuses on the particular aspects of environmental health that communities included in their definitions of a 'healthy community'.

Effects of urbanization on host-pathogen interactions, using Yersinia in house sparrows as a model

PubMed Central

Strubbe, Diederik; Teyssier, Aimeric; Salleh Hudin, Noraine; Van den Abeele, Anne-Marie; Cox, Ivo; Haesendonck, Roel; Delmée, Michel; Haesebrouck, Freddy; Pasmans, Frank; Lens, Luc; Martel, An

2017-01-01

Urbanization strongly affects biodiversity, altering natural communities and often leading to a reduced species richness. Yet, despite its increasingly recognized importance, how urbanization impacts on the health of individual animals, wildlife populations and on disease ecology remains poorly understood. To test whether, and how, urbanization-driven ecosystem alterations influence pathogen dynamics and avian health, we use house sparrows (Passer domesticus) and Yersinia spp. (pathogenic for passerines) as a case study. Sparrows are granivorous urban exploiters, whose western European populations have declined over the past decades, especially in highly urbanized areas. We sampled 329 house sparrows originating from 36 populations along an urbanization gradient across Flanders (Belgium), and used isolation combined with ‘matrix-assisted laser desorption ionization- time of flight mass spectrometry’ (MALDI-TOF MS) and PCR methods for detecting the presence of different Yersinia species. Yersinia spp. were recovered from 57.43% of the sampled house sparrows, of which 4.06%, 53.30% and 69.54% were identified as Y. pseudotuberculosis, Y. enterocolitica and other Yersinia species, respectively. Presence of Yersinia was related to the degree of urbanization, average daily temperatures and the community of granivorous birds present at sparrow capture locations. Body condition of suburban house sparrows was found to be higher compared to urban and rural house sparrows, but no relationships between sparrows’ body condition and presence of Yersinia spp. were found. We conclude that two determinants of pathogen infection dynamics, body condition and pathogen occurrence, vary along an urbanization gradient, potentially mediating the impact of urbanization on avian health. PMID:29281672

Effects of urbanization on host-pathogen interactions, using Yersinia in house sparrows as a model.

PubMed

Rouffaer, Lieze Oscar; Strubbe, Diederik; Teyssier, Aimeric; Salleh Hudin, Noraine; Van den Abeele, Anne-Marie; Cox, Ivo; Haesendonck, Roel; Delmée, Michel; Haesebrouck, Freddy; Pasmans, Frank; Lens, Luc; Martel, An

2017-01-01

Urbanization strongly affects biodiversity, altering natural communities and often leading to a reduced species richness. Yet, despite its increasingly recognized importance, how urbanization impacts on the health of individual animals, wildlife populations and on disease ecology remains poorly understood. To test whether, and how, urbanization-driven ecosystem alterations influence pathogen dynamics and avian health, we use house sparrows (Passer domesticus) and Yersinia spp. (pathogenic for passerines) as a case study. Sparrows are granivorous urban exploiters, whose western European populations have declined over the past decades, especially in highly urbanized areas. We sampled 329 house sparrows originating from 36 populations along an urbanization gradient across Flanders (Belgium), and used isolation combined with 'matrix-assisted laser desorption ionization- time of flight mass spectrometry' (MALDI-TOF MS) and PCR methods for detecting the presence of different Yersinia species. Yersinia spp. were recovered from 57.43% of the sampled house sparrows, of which 4.06%, 53.30% and 69.54% were identified as Y. pseudotuberculosis, Y. enterocolitica and other Yersinia species, respectively. Presence of Yersinia was related to the degree of urbanization, average daily temperatures and the community of granivorous birds present at sparrow capture locations. Body condition of suburban house sparrows was found to be higher compared to urban and rural house sparrows, but no relationships between sparrows' body condition and presence of Yersinia spp. were found. We conclude that two determinants of pathogen infection dynamics, body condition and pathogen occurrence, vary along an urbanization gradient, potentially mediating the impact of urbanization on avian health.

Teacher Consultation and Coaching within Mental Health Practice: Classroom and Child Effects in Urban Elementary Schools

ERIC Educational Resources Information Center

Cappella, Elise; Hamre, Bridget K.; Kim, Ha Yeon; Henry, David B.; Frazier, Stacy L.; Atkins, Marc S.; Schoenwald, Sonja K.

2012-01-01

Objective: To examine effects of a teacher consultation and coaching program delivered by school and community mental health professionals on change in observed classroom interactions and child functioning across one school year. Method: Thirty-six classrooms within 5 urban elementary schools (87% Latino, 11% Black) were randomly assigned to…

[Community vegetable gardens as a health promotion activity: an experience in Primary Healthcare Units].

PubMed

Costa, Christiane Gasparini Araújo; Garcia, Mariana Tarricone; Ribeiro, Silvana Maria; Salandini, Marcia Fernanda de Sousa; Bógus, Cláudia Maria

2015-10-01

Urban and peri-urban agriculture (UPA) is being practiced in different settings, contributing to the improvement of health in communities and healthier environments. In order to identify the meanings and implications of the practice of UPA in Primary Healthcare Units (PHU) as an activity of health promotion (HP), and to what extent its therapeutic dimension characterizes it as an activity aligned with complementary and integrative practices (CIP), a qualitative cross-sectional study was performed in Embu das Artes, State of São Paulo. From the analysis, the following main themes arose: health concept, health outcomes, the return to traditional practices and habits and the reorientation of health services. It was possible to identify the close link between the cultivation of vegetable gardens and HP guidelines and fields of action, such as creating healthier environments, boosting community actions, developing personal skills, stimulating autonomy and empowerment and demands for the reorientation of services. The garden activities, set up in PHU areas, proved to be an implementation strategy of CIP. The conclusion reached is that vegetable gardening activities in community gardens are seen to be health promotion practices that integrate key elements of CIP.

Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria.

PubMed

Onwujekwe, Obinna; Onoka, Chima; Uguru, Nkoli; Nnenna, Tasie; Uzochukwu, Benjamin; Eze, Soludo; Kirigia, Joses; Petu, Amos

2010-06-12

It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts.

Bridging the Response to Mass Shootings and Urban Violence: Exposure to Violence in New Haven, Connecticut.

PubMed

Santilli, Alycia; O'Connor Duffany, Kathleen; Carroll-Scott, Amy; Thomas, Jordan; Greene, Ann; Arora, Anita; Agnoli, Alicia; Gan, Geliang; Ickovics, Jeannette

2017-03-01

We have described self-reported exposure to gun violence in an urban community of color to inform the movement toward a public health approach to gun violence prevention. The Community Alliance for Research and Engagement at Yale School of Public Health conducted community health needs assessments to document chronic disease prevalence and risk, including exposure to gun violence. We conducted surveys with residents in six low-income neighborhoods in New Haven, Connecticut, using a neighborhood-stratified, population-based sample (n = 1189; weighted sample to represent the neighborhoods, n = 29 675). Exposure to violence is pervasive in these neighborhoods: 73% heard gunshots; many had family members or close friends hurt (29%) or killed (18%) by violent acts. Although all respondents live in low-income neighborhoods, exposure to violence differs by race/ethnicity and social class. Residents of color experienced significantly more violence than did White residents, with a particularly disparate increase among young Black men aged 18 to 34 years. While not ignoring societal costs of horrific mass shootings, we must be clear that a public health approach to gun violence prevention means focusing on the dual epidemic of mass shootings and urban violence.

Help-Seeking Behavior among Urban Black Adults.

ERIC Educational Resources Information Center

And Others; Hendricks, Leo E.

1981-01-01

Data were gathered from adult urban Blacks to identify and describe sources of help in dealing with serious problems. Results indicated that the most frequently consulted sources of help were hospitals, community mental health centers, and hotlines. (RC)

Social Networks and Health: Understanding the Nuances of Healthcare Access between Urban and Rural Populations.

PubMed

Amoah, Padmore Adusei; Edusei, Joseph; Amuzu, David

2018-05-13

Communities and individuals in many sub-Saharan African countries often face limited access to healthcare. Hence, many rely on social networks to enhance their chances for adequate health care. While this knowledge is well-established, little is known about the nuances of how different population groups activate these networks to improve access to healthcare. This paper examines how rural and urban dwellers in the Ashanti Region in Ghana distinctively and systematically activate their social networks to enhance access to healthcare. It uses a qualitative cross-sectional design, with in-depth interviews of 79 primary participants (28 urban and 51 rural residents) in addition to the views of eight community leaders and eight health personnel. It was discovered that both intimate and distanced social networks for healthcare are activated at different periods by rural and urban residents. Four main stages of social networks activation, comprising different individuals and groups were observed among rural and urban dwellers. Among both groups, physical proximity, privacy, trust and sense of fairness, socio-cultural meaning attached to health problems, and perceived knowledge and other resources (mainly money) held in specific networks inherently influenced social network activation. The paper posits that a critical analysis of social networks may help to tailor policy contents to individuals and groups with limited access to healthcare.

Online Information Searches and Help Seeking for Mental Health Problems in Urban China.

PubMed

Chen, Juan; Zhu, Shizhan

2016-07-01

In recent years, the Internet has emerged as an alternative information source on mental health problems. Yet, the profile of the typical Internet help seeker is to be determined. Based on data from a household survey of 2558 Beijing residents, the study investigates online information searches and help seeking for mental health problems. Multinomial logistic regressions are estimated for respondents' access to the Internet, and mental-health-related information searches and help seeking on the Internet for the whole community sample and the most psychologically distressed subsample. The study identifies a digital divide in online help seeking for mental health issues based on age, migration and hukou status, and socio-economic factors. Youth and high socio-economic status are significant predictors of Internet access and use. Among the whole community sample, rural-to-urban migrants are less likely to have access to the Internet and search information or seek help online. Among the most psychologically distressed subsample, urban-to-urban migrants are significantly more likely to have access to the Internet and search information or seek help online. Given the shortage of mental health professionals in China, online information dissemination and guided self-help, if properly designed, could offer a means to reach large numbers of individuals in a cost-effective manner.

Promoting Environmental Justice Through Urban Green Space Access: A Synopsis

Treesearch

Viniece Jennings; Cassandra Johnson Gaither; Richard Schulterbrandt Gragg

2012-01-01

This article reviews literature on the connection between urban green space access and environmental justice. It discusses the dynamics of the relationship as it relates to factors such as environmental quality, land use, and environmental health disparities. Urban development stresses the landscape and may compromise environmental quality. Since some communities are...

Urban Health Project: A Sustainable and Successful Community Internship Program for Medical Students.

PubMed

Roberts, Kasey; Park, Thomas; Elder, Nancy C; Regan, Saundra; Theodore, Sarah N; Mitchell, Monica J; Johnson, Yolanda N

2015-11-01

Urban Health Project (UHP) is a mission and vision-driven summer internship at the University of Cincinnati College of Medicine that places first-year medical students at local community agencies that work with underserved populations. At the completion of their internship, students write Final Intern Reflections (FIRs). Final Intern Reflections written from 1987 to 2012 were read and coded to both predetermined categories derived from the UHP mission and vision statements and new categories created from the data themselves. Comments relating to UHP's mission and vision were found in 47% and 36% of FIRs, respectively. Positive experiences outweighed negative by a factor of eight. Interns reported the following benefits: educational (53%), valuable (25%), rewarding (25%), new (10%), unique (6%), and life-changing (5%). Urban Health Project is successful in providing medical students with enriching experiences with underserved populations that have the potential to change their understanding of vulnerable populations.

Decision-Making Phenomena Described by Expert Nurses Working in Urban Community Health Settings.

ERIC Educational Resources Information Center

Watkins, Mary P.

1998-01-01

Expert community health nurses (n=28) described crucial clinical situations. Content analysis revealed that decision making was both rational and intuitive. Eight themes were identified: decision-making focus, type, purpose, decision-maker characteristics, sequencing of events, data collection methods, facilitators/barriers, and decision-making…

The Communication, Awareness, Relationships and Empowerment (C.A.R.E.) Model: An Effective Tool for Engaging Urban Communities in Community-Based Participatory Research

PubMed Central

Ceasar, Joniqua; Peters-Lawrence, Marlene H.; Mitchell, Valerie; Powell-Wiley, Tiffany M.

2017-01-01

Little is known about recruitment methods for racial/ethnic minority populations from resource-limited areas for community-based health and needs assessments, particularly assessments that incorporate mobile health (mHealth) technology for characterizing physical activity and dietary intake. We examined whether the Communication, Awareness, Relationships and Empowerment (C.A.R.E.) model could reduce challenges recruiting and retaining participants from faith-based organizations in predominantly African American Washington, D.C. communities for a community-based assessment. Employing C.A.R.E. model elements, our diverse research team developed partnerships with churches, health organizations, academic institutions and governmental agencies. Through these partnerships, we cultivated a visible presence at community events, provided cardiovascular health education and remained accessible throughout the research process. Additionally, these relationships led to the creation of a community advisory board (CAB), which influenced the study’s design, implementation, and dissemination. Over thirteen months, 159 individuals were recruited for the study, 99 completed the initial assessment, and 81 used mHealth technology to self-monitor physical activity over 30 days. The culturally and historically sensitive C.A.R.E. model strategically engaged CAB members and study participants. It was essential for success in recruitment and retention of an at-risk, African American population and may be an effective model for researchers hoping to engage racial/ethnic minority populations living in urban communities. PMID:29160826

Implementing Participatory Research with an Urban American Indian Community: Lessons Learned

ERIC Educational Resources Information Center

Roberts, Erica B.; Jette, Shannon L.

2016-01-01

Objective: Participatory research has proven an effective method for improving health equity among American Indians/Alaska Natives (AI/ANs) by addressing power imbalances between communities and researchers, incorporating community knowledge and theory, ensuring mutual benefit and improving community capacity and programme sustainability. However,…

Using educational games to promote the seeking of a pharmacist and to teach key medication use messages: results from an inner city health party.

PubMed

Burghardt, Kyle J; Bowman, Margo R; Hibino, Maho; Opong-Owusu, Barima K; Pokora, Tiffany D; Reeves, Katherine; Vile, Kellie M

2013-01-01

Low health literacy affects 80-90 million Americans with low-income, minority populations being more vulnerable to this condition. One method of addressing limited literacy that may be particularly well accepted within vulnerable populations is the use of educational board games in order to emphasize seeking health information from reliable sources such as pharmacists. The research objective was to determine if the use of educational board games could impact community pharmacy patron intentions to seek pharmacist advice in an urban, minority, economically-disadvantaged population. Four medication-related educational games were played at an urban community pharmacy under the leadership of pharmacy students in the setting of a health party. Game messages, design, and evaluation processes were uniquely guided by community members' input. A verbally administered questionnaire measured game impact via knowledge and perception questions with responses compared between a non-randomly allocated intervention group and a control group. Ninety-nine adults were included in the intervention (or game) group and 94 adults were in the control group. Game participants were significantly more likely than the control group to indicate they would seek pharmacist medication advice in the future. Educational board games played in the setting of a health party can be a fun and effective way to convey selected health messages within an urban, minority, economically disadvantaged population. Community input into game development and layering multiple strategies for overcoming health literacy barriers were essential components of this initiative. Published by Elsevier Inc.

Ectomycorrhizal Fungal Communities in Urban Parks Are Similar to Those in Natural Forests but Shaped by Vegetation and Park Age

PubMed Central

Liu, Xinxin; Kotze, D. Johan; Jumpponen, Ari; Francini, Gaia; Setälä, Heikki

2017-01-01

ABSTRACT Ectomycorrhizal (ECM) fungi are important mutualists for the growth and health of most boreal trees. Forest age and its host species composition can impact the composition of ECM fungal communities. Although plentiful empirical data exist for forested environments, the effects of established vegetation and its successional trajectories on ECM fungi in urban greenspaces remain poorly understood. We analyzed ECM fungi in 5 control forests and 41 urban parks of two plant functional groups (conifer and broadleaf trees) and in three age categories (10, ∼50, and >100 years old) in southern Finland. Our results show that although ECM fungal richness was marginally greater in forests than in urban parks, urban parks still hosted rich and diverse ECM fungal communities. ECM fungal community composition differed between the two habitats but was driven by taxon rank order reordering, as key ECM fungal taxa remained largely the same. In parks, the ECM communities differed between conifer and broadleaf trees. The successional trajectories of ECM fungi, as inferred in relation to the time since park construction, differed among the conifers and broadleaf trees: the ECM fungal communities changed over time under the conifers, whereas communities under broadleaf trees provided no evidence for such age-related effects. Our data show that plant-ECM fungus interactions in urban parks, in spite of being constructed environments, are surprisingly similar in richness to those in natural forests. This suggests that the presence of host trees, rather than soil characteristics or even disturbance regime of the system, determine ECM fungal community structure and diversity. IMPORTANCE In urban environments, soil and trees improve environmental quality and provide essential ecosystem services. ECM fungi enhance plant growth and performance, increasing plant nutrient acquisition and protecting plants against toxic compounds. Recent evidence indicates that soil-inhabiting fungal communities, including ECM and saprotrophic fungi, in urban parks are affected by plant functional type and park age. However, ECM fungal diversity and its responses to urban stress, plant functional type, or park age remain unknown. The significance of our study is in identifying, in greater detail, the responses of ECM fungi in the rhizospheres of conifer and broadleaf trees in urban parks. This will greatly enhance our knowledge of ECM fungal communities under urban stresses, and the findings can be utilized by urban planners to improve urban ecosystem services. PMID:28970220

NIEHS/EPA CEHCs: Children's Environmental Health and Disease Prevention Center - Dartmouth College

EPA Pesticide Factsheets

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

NIEHS/EPA CEHCs: Columbia Center for Children’s Environmental Health - Columbia University

EPA Pesticide Factsheets

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

The association between urbanization and reduced renal function: findings from the China Health and Nutrition Survey.

PubMed

Inoue, Yosuke; Howard, Annie Green; Thompson, Amanda L; Mendez, Michelle A; Herring, Amy H; Gordon-Larsen, Penny

2017-05-15

While chronic kidney disease (CKD) is a growing public health concern in low- and middle-income countries, such as China, few studies have investigated the association between urbanization and the occurrence of CKD in those countries. We investigated the association between urbanization and estimated glomerular filtration rate (eGFR), an important CKD risk marker. Data came from the China Health and Nutrition Survey wave 2009, in which we collected fasting serum, individual and household data along with community level urbanization data, which was used to derive a study-specific urbanization measure, in 218 communities across nine provinces. A total of 3644 men and 4154 women participants aged 18 years or older were included in the analysis. Reduced renal function was defined as eGFR of less than 60 mL/min/1.73 m 2 measured using serum creatinine concentration (mg/dL). After adjusting for socio-demographic (e.g., age, education and household income), a sex-stratified multilevel logistic model revealed that living in a more urbanized community was associated with higher odds of reduced eGFR (odds ratio [OR] = 1.38 per one-standard deviation [SD] increase in the CHNS specific urbanization index, 95% confidence interval [CI] = 1.11-1.73 for men; OR = 1.35, 95% CI = 1.11-1.62 for women). After adjusting for behavioral variables (i.e., alcohol consumption, smoking, physical activity and diet), as well as obesity and cardiometabolic risk factors, the association was attenuated in men (OR = 1.25, 95% CI = 0.98-1.59), but remained statistically significant in women (OR = 1.24, 95% CI = 1.01-1.52). Our findings suggest that living in an urban environment is linked with higher odds of reduced renal function independently of behavioral and cardiometabolic risk factors, which have been shown to increase along with urbanization.

Predictors of firearm violence in urban communities: A machine-learning approach.

PubMed

Goin, Dana E; Rudolph, Kara E; Ahern, Jennifer

2018-05-01

Interpersonal firearm violence is a leading cause of death and injuries in the United States. Identifying community characteristics associated with firearm violence is important to improve confounder selection and control in health research, to better understand community-level factors that are associated with firearm violence, and to enhance community surveillance and control of firearm violence. The objective of this research was to use machine learning to identify an optimal set of predictors for urban interpersonal firearm violence rates using a broad set of community characteristics. The final list of 18 predictive covariates explain 77.8% of the variance in firearm violence rates, and are publicly available, facilitating their inclusion in analyses relating violence and health. This list includes the black isolation and segregation indices, rates of educational attainment, marital status, indicators of wealth and poverty, longitude, latitude, and temperature. Copyright © 2018 Elsevier Ltd. All rights reserved.

Disparities in obesity among rural and urban residents in a health disparate region.

PubMed

Hill, Jennie L; You, Wen; Zoellner, Jamie M

2014-10-08

The burden of obesity and obesity-related conditions is not borne equally and disparities in prevalence are well documented for low-income, minority and rural adults in the United States. The current literature on rural versus urban disparities is largely derived from national surveillance data which may not reflect regional nuances. There is little practical research that supports the reality of local service providers such as county health departments that may serve both urban and rural residents in a given area. Conducted through a community-academic partnership, the primary aim of this study is to quantify the current levels of obesity (BMI), fruit and vegetable (FV) intake and physical activity (PA) in a predominately rural health disparate region. Secondary aims are to determine if a gradient exists within the region in which rural residents have poorer outcomes on these indicators compared to urban residents. Conducted as part of a larger ongoing community-based participatory research (CBPR) initiative, data were gathered through a random digit dial telephone survey using previously validated measures (n = 784). Linear, logistic and quantile regression models are used to determine if residency (i.e. rural, urban) predicts outcomes of FV intake, PA and BMI. The majority (72%) of respondents were overweight (BMI = 29 ± 6 kg/m2), with 29% being obese. Only 9% of residents met recommendations for FV intake and 38% met recommendations for PA. Statistically significant gradients between urban and rural and race exist at the upper end of the BMI distribution. In other words, the severity of obesity is worse among black compared to white and for urban residents compared to rural residents. These results will be used by the community-academic partnership to guide the development of culturally relevant and sustainable interventions to increase PA, increase FV intake and reduce obesity within this health disparate region. In particular, local stakeholders may wish to address disparities in BMI by allocating resources to the vulnerable groups identified.

Challenging urban health: towards an improved local government response to migration, informal settlements, and HIV in Johannesburg, South Africa

PubMed Central

Vearey, Joanna

2011-01-01

This article is a review of the PhD thesis undertaken by Joanna Vearey that explores local government responses to the urban health challenges of migration, informal settlements, and HIV in Johannesburg, South Africa. Urbanisation in South Africa is a result of natural urban growth and (to a lesser extent) in-migration from within the country and across borders. This has led to the development of informal settlements within and on the periphery of urban areas. The highest HIV prevalence nationally is found within urban informal settlements. South African local government has a ‘developmental mandate’ that calls for government to work with citizens to develop sustainable interventions to address their social, economic, and material needs. Through a mixed-methods approach, four studies were undertaken within inner-city Johannesburg and a peripheral urban informal settlement. Two cross-sectional surveys – one at a household level and one with migrant antiretroviral clients – were supplemented with semi-structured interviews with multiple stakeholders involved with urban health and HIV in Johannesburg, and participatory photography and film projects undertaken with urban migrant communities. The findings show that local government requires support in developing and implementing appropriate intersectoral responses to address urban health. Existing urban health frameworks do not deal adequately with the complex health and development challenges identified; it is essential that urban public health practitioners and other development professionals in South Africa engage with the complexities of the urban environment. A revised, participatory approach to urban health – ‘concept mapping’ – is suggested which requires a recommitment to intersectoral action, ‘healthy urban governance’ and public health advocacy. PMID:21686331

Impact of dropout of female volunteer community health workers: An exploration in Dhaka urban slums

PubMed Central

2012-01-01

Background The model of volunteer community health workers (CHWs) is a common approach to serving the poor communities in developing countries. BRAC, a large NGO in Bangladesh, is a pioneer in this area, has been using female CHWs as core workers in its community-based health programs since 1977. After 25 years of implementing of the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through a community-based maternal health intervention. However, BRAC experiences high dropout rates among CHWs suggesting a need to better understand the impact of their dropout which would help to reduce dropout and increase program sustainability. The main objective of the study was to estimate impact of dropout of volunteer CHWs from both BRAC and community perspectives. Also, we estimated cost of possible strategies to reduce dropout and compared whether these costs were more or less than the costs borne by BRAC and the community. Methods We used the ‘ingredient approach’ to estimate the cost of recruiting and training of CHWs and the so-called ‘friction cost approach’ to estimate the cost of replacement of CHWs after adapting. Finally, we estimated forgone services in the community due to CHW dropout applying the concept of the friction period. Results In 2009, average cost per regular CHW was US$ 59.28 which was US$ 60.04 for an ad-hoc CHW if a CHW participated a three-week basic training, a one-day refresher training, one incentive day and worked for a month in the community after recruitment. One month absence of a CHW with standard performance in the community meant substantial forgone health services like health education, antenatal visits, deliveries, referrals of complicated cases, and distribution of drugs and health commodities. However, with an additional investment of US$ 121 yearly per CHW BRAC could save another US$ 60 invested an ad-hoc CHW plus forgone services in the community. Conclusion Although CHWs work as volunteers in Dhaka urban slums impact of their dropout is immense both in financial term and forgone services. High cost of dropout makes the program less sustainable. However, simple and financially competitive strategies can improve the sustainability of the program. PMID:22897922

The diversity in associations between community social capital and health per health outcome, population group and location studied.

PubMed

van Hooijdonk, Carolien; Droomers, Mariël; Deerenberg, Ingeborg M; Mackenbach, Johan P; Kunst, Anton E

2008-12-01

Literature on the effect of community social capital on health is inconsistent and could be related to differences in social capital measures, health outcomes, population groups and locations studied. Therefore this study examines the diversity in associations between community social capital and health by investigating different diseases, populations groups and locations. Mortality records and individual data on sex, age, marital status, ethnic origin and place of residence were available for 6 years (1995-2000). Neighbourhood data, i.e. community social capital, socio-economic level and urbanicity, were linked through postcode information. Community social capital was indicated by measures of community interaction, belongingness, satisfaction and involvement. Variations in all-cause and cause-specific mortality across low and high social capital neighbourhoods were estimated through Poisson regression. In addition, analyses were stratified according to population group and to urbanization level. In the total population, community social capital was not related to all-cause mortality (RR = 1.00; CI: 0.99-1.01). However, residents of high social capital neighbourhoods had lower mortality risks for cancer [especially lung cancer (RR = 0.92; CI: 0.89-0.96)] and for suicide (RR = 0.90; CI: 0.83-0.98). Slightly lower mortality risks were also found for men (RR = 0.98; CI: 0.97-0.99), married individuals (RR = 0.96; CI: 0.94-0.97) and for residents living in socially strong neighbourhoods located in large cities (RR = 0.95; CI: 0.91-0.99). The association between community social capital and health differs per health outcome, study population and location studied. This underlines the need to take such diversity into account when aiming to conceptualize the relation between community social capital and health.

The Koori Growing Old Well Study: investigating aging and dementia in urban Aboriginal Australians.

PubMed

Radford, Kylie; Mack, Holly A; Robertson, Hamish; Draper, Brian; Chalkley, Simon; Daylight, Gail; Cumming, Robert; Bennett, Hayley; Jackson Pulver, Lisa; Broe, Gerald A

2014-06-01

Dementia is an emerging health priority in Australian Aboriginal communities, but substantial gaps remain in our understanding of this issue, particularly for the large urban section of the population. In remote Aboriginal communities, high prevalence rates of dementia at relatively young ages have been reported. The current study is investigating aging, cognitive decline, and dementia in older urban/regional Aboriginal Australians. We partnered with five Aboriginal communities across the eastern Australian state of New South Wales, to undertake a census of all Aboriginal men and women aged 60 years and over residing in these communities. This was followed by a survey of the health, well-being, and life history of all consenting participants. Participants were also screened using three cognitive instruments. Those scoring below designated cut-offs, and a 20% random sample of those scoring above (i.e. "normal" range), completed a contact person interview (with a nominated family member) and medical assessment (blind to initial screening results), which formed the basis of "gold standard" clinical consensus determinations of cognitive impairment and dementia. This paper details our protocol for a population-based study in collaboration with local Aboriginal community organizations. The study will provide the first available prevalence rates for dementia and cognitive impairment in a representative sample of urban Aboriginal people, across city and rural communities, where the majority of Aboriginal Australians live. It will also contribute to improved assessment of dementia and cognitive impairment and to the understanding of social determinants of successful aging, of international significance.

Assessing and quantifying high risk: comparing risky behaviors by youth in an urban, disadvantaged community with nationally representative youth.

PubMed

Swahn, Monica H; Bossarte, Robert M

2009-01-01

This study examined whether youth who live in an urban, disadvantaged community are significantly more likely than youth representing the nation to engage in a range of health-compromising behaviors. Analyses were based on the Youth Violence Survey conducted in 2004 and administered to students (n=4131) in a high-risk school district. Students in ninth grade (n=1114) were compared with ninth-grade students in the 2003 national Youth Risk Behavior Survey (n=3674) and the National Longitudinal Study of Adolescent Health conducted in 1995/1996 (n=3523). Analyses assessed the differences in prevalence of risk and protective factors among ninth-grade students from the three studies using Chi-square tests. The results showed that youth in this urban, disadvantaged community were significantly more likely than their peers across the country to report vandalism, theft, violence, and selling drugs. Youth in this community also reported significantly less support from their homes and schools, and less monitoring by their parents. Moreover, youth in this community were significantly less likely to binge drink or initiate alcohol use prior to age 13 than youth across the U.S. Youth who live in this urban, disadvantaged community reported significantly higher prevalence of some, but not all, risky behaviors than nationally representative U.S. youth. These findings highlight that some caution is justified when defining what might constitute high risk and that demographic and other characteristics need to be carefully considered when targeting certain high-risk behaviors.

Community Gardens as Environmental Health Interventions: Benefits Versus Potential Risks.

PubMed

Al-Delaimy, W K; Webb, M

2017-06-01

The purpose of this paper was to summarize current findings on community gardens relevant to three specific areas of interest as follows: (1) health benefits, (2) garden interventions in developing versus developed countries, and (3) the concerns and risks of community gardening. Community gardens are a reemerging phenomenon in many low- and high-income urban neighborhoods to address the common risk factors of modern lifestyle. Community gardens are not limited to developed countries. They also exist in developing low-income countries but usually serve a different purpose of food security. Despite their benefits, community gardens can become a source of environmental toxicants from the soil of mostly empty lands that might have been contaminated by toxicants in the past. Therefore, caution should be taken about gardening practices and the types of foods to be grown on such soil if there was evidence of contamination. We present community gardens as additional solutions to the epidemic of chronic diseases in low-income urban communities and how it can have a positive physical, mental and social impact among participants. On balance, the benefits of engaging in community gardens are likely to outweigh the potential risk that can be remedied. Quantitative population studies are needed to provide evidence of the benefits and health impacts versus potential harms from community gardens.

A Return to "The Clinic" for Community Psychology: Lessons from a Clinical Ethnography in Urban American Indian Behavioral Health.

PubMed

Hartmann, William E; St Arnault, Denise M; Gone, Joseph P

2018-03-01

Community psychology (CP) abandoned the clinic and disengaged from movements for community mental health (CMH) to escape clinical convention and pursue growing aspirations as an independent field of context-oriented, community-engaged, and values-driven research and action. In doing so, however, CP positioned itself on the sidelines of influential contemporary movements that promote potentially harmful, reductionist biomedical narratives in mental health. We advocate for a return to the clinic-the seat of institutional power in mental health-using critical clinic-based inquiry to open sites for clinical-community dialogue that can instigate transformative change locally and nationally. To inform such works within the collaborative and emancipatory traditions of CP, we detail a recently completed clinical ethnography and offer "lessons learned" regarding challenges likely to re-emerge in similar efforts. Conducted with an urban American Indian community behavioral health clinic, this ethnography examined how culture and culture concepts (e.g., cultural competence) shaped clinical practice with socio-political implications for American Indian peoples and the pursuit of transformative change in CMH. Lessons learned identify exceptional clinicians versed in ecological thinking and contextualist discourses of human suffering as ideal partners for this work; encourage intense contextualization and constraining critique to areas of mutual interest; and support relational approaches to clinic collaborations. © Society for Community Research and Action 2017.

Indicators to support healthy urban gardening in urban management.

PubMed

Schram-Bijkerk, Dieneke; Otte, Piet; Dirven, Liesbet; Breure, Anton M

2018-04-15

Urban gardening is part of a trend towards more parks and green areas in cities, consumption of organic, locally grown products, and a closer relationship with one's own living environment. Our literature review shows that urban gardens provide opportunities for physical activity and allow people to consume homegrown fruit and vegetables. Urban gardens may also reduce stress levels of gardeners and improve social cohesion. In this way, they can help to prevent health problems. Good quality of urban soil and the functioning of soil ecosystems are indispensable prerequisites for these. We developed a framework that shows how ecosystem health and human health are interconnected in urban gardening, by placing it in the context of urban green space management and valuation. This study yields a set of indicators, which can be used to assess soil ecosystem services and health impacts. They may provide a basis for the evolving dialogue in decision-making processes and partnership activities in urban management. Recognizing the potential effects and discussing what is important to whom, might be enough to find synergies. Importantly, the initiators of urban gardens are often citizens, who seek support from other stakeholders. The social network established by gardens may contribute to health-enabling, cohesive communities involved with their living environment. To maximize health benefits, it is useful to make the urban gardens accessible to many people. This study suggests that urban gardens deserve a position in urban green space management as they may help to address societal challenges like urbanization, health and well-being in aging populations and climate adaptation. Copyright © 2017 Elsevier B.V. All rights reserved.

Building beyond the Evaluation Of Environmental Education and Sustainable Development in African Schools and Communities: The Women Global Green Action Network (WGGAN) Africa Perspective

ERIC Educational Resources Information Center

Enie, Rosemary Olive Mbone

2006-01-01

This article describes the Community Health Education and School Sanitation (CHESS) Project, an initiative by the Women Global Green Action Network International to support community-based environmental projects in Africa. The CHESS Project uses women, children and youth to develop more sustainable health and sanitation systems in urban and rural…

Future Sex Educator Perceptions of Rural versus Urban Instruction: A Case for Community-Centered Sexual Health Education

ERIC Educational Resources Information Center

Jones, Christina L.; Jensen, Robin E.; Selzer King, Abigail

2014-01-01

Instructors of sexual health courses in rural areas face unique challenges as they are often forced to use school-based prevention curricula field-tested in urban areas. Research has yet to consider what future sex educators' regional expectations are for their profession and how those expectations might have an impact on the classroom. Drawing…

A pre-and-post study of an urban renewal program in a socially disadvantaged neighbourhood in Sydney, Australia

PubMed Central

2012-01-01

Background Urban renewal programs aim to target both the physical and social environments to improve the social capital, social connectedness, sense of community and economic conditions of residents of the neighbourhoods. We evaluated the impact of an urban renewal program on the health and well-being of residents of a socially disadvantaged community in south-western Sydney, Australia. Methods Pre- and post-urban renewal program surveys were conducted with householders by trained interviewers. The urban renewal program was conducted over 16 months and consisted of internal upgrades (including internal painting; replacement of kitchens, bathrooms and carpets; general maintenance), external upgrades (including property painting; new fencing, carports, letterboxes, concrete driveways, drainage and landscaping), general external maintenance, and social interventions such as community engagement activities, employment initiatives, and building a community meeting place. The questionnaire asked about demographic characteristics, self-reported physical activity, psychological distress, self-rated health, and perceptions of aesthetics, safety and walkability in the neighbourhood. We used the paired chi-square test (McNemars test) to compare paired proportions. A Bonferroni corrected p-value of <0.0013 denoted statistical significance. Results Following the urban renewal program we did not find statistically significant changes in perceptions of aesthetics, safety and walkability in the neighbourhood. However, post-urban renewal, more householders reported there were attractive buildings and homes in their neighbourhood (18% vs 64%), felt that they belonged to the neighbourhood (48% vs 70%), that their area had a reputation for being a safe place (8% vs 27%), that they felt safe walking down their street after dark (52% vs 85%), and that people who came to live in the neighbourhood would be more likely to stay rather than move elsewhere (13% vs 54%). Changes in psychological distress and self-rated health were not statistically significant. Conclusions We found an increase, in the short-term, in the proportion of householders reporting improvements in some aspects of their immediate neighbourhood following the urban renewal program. It will be important to repeat the survey in the future to determine whether these positive changes are sustained. PMID:22788536

A pre-and-post study of an urban renewal program in a socially disadvantaged neighbourhood in Sydney, Australia.

PubMed

Jalaludin, Bin; Maxwell, Michelle; Saddik, Basema; Lobb, Elizabeth; Byun, Roy; Gutierrez, Rodrigo; Paszek, John

2012-07-12

Urban renewal programs aim to target both the physical and social environments to improve the social capital, social connectedness, sense of community and economic conditions of residents of the neighbourhoods. We evaluated the impact of an urban renewal program on the health and well-being of residents of a socially disadvantaged community in south-western Sydney, Australia. Pre- and post-urban renewal program surveys were conducted with householders by trained interviewers. The urban renewal program was conducted over 16 months and consisted of internal upgrades (including internal painting; replacement of kitchens, bathrooms and carpets; general maintenance), external upgrades (including property painting; new fencing, carports, letterboxes, concrete driveways, drainage and landscaping), general external maintenance, and social interventions such as community engagement activities, employment initiatives, and building a community meeting place. The questionnaire asked about demographic characteristics, self-reported physical activity, psychological distress, self-rated health, and perceptions of aesthetics, safety and walkability in the neighbourhood. We used the paired chi-square test (McNemars test) to compare paired proportions. A Bonferroni corrected p-value of <0.0013 denoted statistical significance. Following the urban renewal program we did not find statistically significant changes in perceptions of aesthetics, safety and walkability in the neighbourhood. However, post-urban renewal, more householders reported there were attractive buildings and homes in their neighbourhood (18% vs 64%), felt that they belonged to the neighbourhood (48% vs 70%), that their area had a reputation for being a safe place (8% vs 27%), that they felt safe walking down their street after dark (52% vs 85%), and that people who came to live in the neighbourhood would be more likely to stay rather than move elsewhere (13% vs 54%). Changes in psychological distress and self-rated health were not statistically significant. We found an increase, in the short-term, in the proportion of householders reporting improvements in some aspects of their immediate neighbourhood following the urban renewal program. It will be important to repeat the survey in the future to determine whether these positive changes are sustained.

Contextualizing mental health: gendered experiences in a Mumbai slum.

PubMed

Parkar, Shubhangi R; Fernandes, Johnson; Weiss, Mitchell G

2003-12-01

Urban mental health programmes in developing countries remain in their infancy. To serve low-income communities, research needs to consider the impact of common life experience in slums, including poverty, bad living conditions, unemployment, and crowding. Our study in the Malavani slum of Mumbai examines afflictions of the city affecting the emotional well-being and mental health of women and men with respect to gender. This is a topic for which mental health studies have been lacking, and for which psychiatric assumptions based on middle-class clinical experience may be most tenuous. This study employs ethnographic methods to show how environmental and social contexts interact in shaping local experience with reference to common mental health problems. Focusing on the social and environmental context of the mental health of communities, rather than psychiatric disorders affecting individuals, findings are broadly applicable and sorely needed to guide the development of locally appropriate community mental health programmes. Identified afflictions affecting mental health include not only access to health care, but also sanitation, addictions, criminality, domestic violence, and the so-called bar-girl culture. Although effective clinical interventions are required for mental health services to treat psychiatric disorders, they cannot directly affect the conditions of urban slums that impair mental health.

Urban development results in stressors that degrade stream ecosystems

USGS Publications Warehouse

Bell, Amanda H.; Coles, James F.; McMahon, Gerard; Woodside, Michael D.

2012-01-01

In 2003, eighty-three percent of Americans lived in metropolitan areas, and considerable population increases are predicted within the next 50 years. Nowhere are the environmental changes associated with urban development more evident than in urban streams. Contaminants, habitat destruction, and increasing streamflow flashiness resulting from urban development have been associated with the disruption of biological communities, particularly the loss of sensitive aquatic biota. Every stream is connected downstream to other water bodies, and inputs of contaminants and (or) sediments to streams can cause degradation downstream with adverse effects on biological communities and on economically valuable resources, such as fisheries and tourism. Understanding how algal, invertebrate, and fish communities respond to physical and chemical stressors associated with urban development can provide important clues on how multiple stressors may be managed to protect stream health as a watershed becomes increasingly urbanized. This fact sheet highlights selected findings of a comprehensive assessment by the National Water-Quality Assessment Program of the U.S. Geological Survey (USGS) of the effects of urban development on stream ecosystems in nine metropolitan study areas.

Rural–urban differences in exposure to adverse childhood experiences among South Carolina adults.

PubMed

Radcliff, Elizabeth; Crouch, Elizabeth; Strompolis, Melissa

2018-02-01

Adverse childhood experiences (ACEs) are traumatic events that occur in a child's life between birth and 18 years. Exposure to one or more ACE has been linked to participation in risky health behaviors and the experience of chronic health conditions in adulthood. The risk for poor outcomes increases as the number of ACEs experienced increases. This research investigates rural-urban differences in exposure to ACEs using a sample from a representative southern US state, South Carolina. Using data from the 2014-2015 South Carolina Behavioral Risk Factor Surveillance System (BRFSS) and residential rurality based on UICs, ACE exposure among South Carolina adults was tabulated by urban versus rural residence and selected other demographic characteristics. Using standard descriptive statistics, frequencies and proportions were calculated for each categorical variable. Multivariable regression modeling was used to examine the impact of residential rurality and selected sociodemographic characteristics on overall and specific types of ACE exposure. All analyses used survey sampling weights that accounted for the BRFSS sampling strategy. The analytic sample of 18 176 respondents comprised 15.9% rural residents. Top reported ACEs for both rural and urban residents were the same: parental divorce/separation, emotional abuse, and household substance use. Compared to urban residents, a higher proportion of rural respondents reported experiencing no ACEs (41.4% vs 38.3%, p<0.01). The prevalence of four or more ACEs in rural respondents was 15.0%; in comparison, 17.6% of urban respondents had four or more ACEs (p<0.01). In logistic regression predicting exposure to four or more ACEs and adjusting for sex, age, race/ethnicity, education, and income, rural respondents were less likely than urban respondents to report four or more ACEs (adjusted odds ratio 0.75, 95% confidence interval 0.74-0.75). Despite reporting less ACE exposure than urban counterparts, almost 60% of rural residents reported at least one ACE and 15% reported experiencing four or more ACEs. In contrast to urban residents, rural residents may experience more social connections within their families and communities, which may influence ACE exposure; however, care coordination, social support services, and access to health care are limited in rural areas. Thus, families in rural areas may be less equipped to mitigate and manage the effects of ACEs. Findings from this study thus suggest that interventions to prevent ACE exposure are just as needed in rural southern communities as they are in urban southern communities. Topics important for future research could include an examination of ACEs in rural communities in terms of individuals' health outcomes and their access to health care, as well as the role of protective factors. Programs and policies that assist in ACE prevention in rural areas are important to reducing these multigenerational threats to health and wellbeing.

24 CFR 582.100 - Program component descriptions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... organizations. A sponsor may be a private, nonprofit organization or a community mental health agency... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES SHELTER PLUS CARE Assistance Provided § 582.100 Program...

Urban–Rural Differences in Health-Care-Seeking Pattern of Residents of Abia State, Nigeria, and the Implication in the Control of NCDs

PubMed Central

Onyeonoro, Ugochukwu U.; Ogah, Okechukwu S.; Ukegbu, Andrew U.; Chukwuonye, Innocent I.; Madukwe, Okechukwu O.; Moses, Akhimiem O.

2016-01-01

BACKGROUND Understanding the differences in care-seeking pattern is key in designing interventions aimed at improving health-care service delivery, including prevention and control of noncommunicable diseases. The aim of this study was to identify the differences and determinants of care-seeking patterns of urban and rural residents in Abia State in southeast Nigeria. METHODS This was a cross-sectional, community-based, study involving 2999 respondents aged 18 years and above. Data were collected using the modified World Health Organization’s STEPS questionnaire, including data on care seeking following the onset of illness. Descriptive statistics and logistic regressions were used to analyze care-seeking behavior and to identify differences among those seeking care in urban and rural areas. RESULTS In both urban and rural areas, patent medicine vendors (73.0%) were the most common sources of primary care following the onset of illness, while only 20.0% of the participants used formal care. Significant predictors of difference in care-seeking practices between residents in urban and rural communities were educational status, income, occupation, and body mass index. CONCLUSIONS Efforts should be made to reduce barriers to formal health-care service utilization in the state by increasing health insurance coverage, strengthening the health-care system, and increasing the role of patent medicine vendors in the formal health-care delivery system. PMID:27721654

Perceived Benefits of Participation and Risks of Soil Contamination in St. Louis Urban Community Gardens.

PubMed

Wong, Roger; Gable, Leah; Rivera-Núñez, Zorimar

2018-06-01

Community gardens are credited for promoting health within neighborhoods, by increasing healthy food intake and exercise frequency. These benefits, however, are potentially undermined as urban soils are often contaminated from industrial legacies. The purpose of this study was to examine the perceived benefits of participation and risks of soil contamination within urban community gardens, and factors associated with soil contamination concerns. Ninety-three gardeners were interviewed across 20 community gardens in St. Louis, Missouri between June and August 2015. Surveys included questions on demographics, gardening practices, and perceptions of community gardening. Multilevel logistic models assessed how gardener demographics, gardening practices, and garden characteristics were associated with soil contamination concerns. Common perceived benefits of community gardening were community building (68.8%), healthy and fresh food (35.5%), and gardening education (18.3%). Most gardeners (62.4%) were not concerned about soil contamination, but nearly half (48.4%) stated concerns about heavy metals. Black race was significantly associated with soil contamination concerns (OR 5.47, 95% CI 1.00-30.15, p = .04). Community gardens offer numerous social and health benefits. Although most gardeners were not concerned about soil contamination, black gardeners were more likely to have concerns. Garden leaders should provide resources to gardeners to learn about soil contamination and methods to manage their risk, particularly in minority neighborhoods.

Redesigning community mental health services for urban children: Supporting schooling to promote mental health.

PubMed

Atkins, Marc S; Shernoff, Elisa S; Frazier, Stacy L; Schoenwald, Sonja K; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-10-01

This study examined a school- and home-based mental health service model, Links to Learning, focused on empirical predictors of learning as primary goals for services in high-poverty urban communities. Teacher key opinion leaders were identified through sociometric surveys and trained, with mental health providers and parent advocates, on evidence-based practices to enhance children's learning. Teacher key opinion leaders and mental health providers cofacilitated professional development sessions for classroom teachers to disseminate 2 universal (Good Behavior Game, peer-assisted learning) and 2 targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by mental health providers and parent advocates for children in kindergarten through 4th grade diagnosed with 1 or more disruptive behavior disorders. Services were Medicaid-funded through 4 social service agencies (N = 17 providers) in 7 schools (N = 136 teachers, 171 children) in a 2 (Links to Learning vs. services as usual) × 6 (pre- and posttests for 3 years) longitudinal design with random assignment of schools to conditions. Services as usual consisted of supported referral to a nearby social service agency. Mixed effects regression models indicated significant positive effects of Links to Learning on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-groups effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum-based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high-poverty urban communities. (c) 2015 APA, all rights reserved).

Prevalence, awareness, treatment and control of hypertension in urban poor communities in Accra, Ghana.

PubMed

Awuah, Raphael B; Anarfi, John K; Agyemang, Charles; Ogedegbe, Gbenga; Aikins, Ama de-Graft

2014-06-01

Hypertension is a major public health problem in many sub-Saharan African countries including Ghana, but data on urban poor communities are limited. The aim of this study was therefore to assess the prevalence, awareness, management and control of hypertension among a young adult population in their reproductive ages living in urban poor communities in Accra. Cross-sectional, population-based survey of 714 young adults in their reproductive ages (women aged 15-49 years, men aged 15-59 years) living in three urban poor suburbs of Accra, Ghana. The overall prevalence of hypertension in all three communities was 28.3% (women 25.6% and men 31.0%). Among respondents who had hypertension, 7.4% were aware of their condition; 4% were on antihypertensive medication while only 3.5% of hypertensive individuals had adequate blood pressure (BP) control (BP <140/90  mmHg). The level of awareness and treatment was lower in men than in women (3.1 and 1.3% for men and 11.9 and 6.5% for women, respectively). Among individuals with hypertension, the rate of control was higher among women than among men (5.0 and 2.1%, respectively). Although about a quarter of the young adult population in these low-income communities of Accra have hypertension, the levels of awareness, treatment and control are abysmally low. We recommend community-specific primary and secondary prevention interventions that draw on existing resources, specifically implementing cardiovascular disease (CVD) interventions in faith-based organizations and task-shifting CVD care through the national Community-based Health Planning and Services (CHPS) programme.

Biophilia, health, and well-being

Treesearch

Judith Heerwagen

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

NIEHS/EPA Children’s Environmental Health Centers: Lifecourse Exposures & Diet: Epigenetics, Maturation & Metabolic Syndrome

EPA Pesticide Factsheets

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

'Whose failure counts?' A critical reflection on definitions of failure for community health volunteers providing HIV self-testing in a community-based HIV/TB intervention study in urban Malawi.

PubMed

Sambakunsi, Rodrick; Kumwenda, Moses; Choko, Augustine; Corbett, Elizabeth L; Desmond, Nicola Ann

2015-12-01

The category of community health worker applied within the context of health intervention trials has been promoted as a cost-effective approach to meeting study objectives across large populations, relying on the promotion of the concept of 'community belonging' to encourage altruistic volunteerism from community members to promote health. This community-based category of individuals is recruited to facilitate externally driven priorities defined by large research teams, outside of the target research environment. An externally defined intervention is then 'brought to' the community through locally recruited community volunteers who form a bridge between the researchers and participants. The specific role of these workers is context-driven and responsive to the needs of the intervention. This paper is based on the findings from an annual evaluation of community health worker performance employed as community counsellors to deliver semi-supervised HIV self-testing (HIVST) at community level of a large HIV/TB intervention trial conducted in urban Blantyre, Malawi. A performance evaluation was conducted to appraise individual service delivery and assess achievements in meeting pre-defined targets for uptake of HIVST with the aim of improving overall uptake of HIVST. Through an empirical 'evaluation of the evaluation' this paper critically reflects on the position of the community volunteer through the analytical lens of 'failure', exploring the tensions in communication and interpretation of intervention delivery between researchers and community volunteers and the differing perspectives on defining failure. It is concluded that community interventions should be developed in collaboration with the population and that information guiding success should be clearly defined.

Community perception regarding rabies prevention and stray dog control in urban slums in India.

PubMed

Herbert, Mrudu; Riyaz Basha, S; Thangaraj, Selvi

2012-12-01

The lack of community awareness about rabies control is a major issue that thwarts efforts to prevent human deaths caused by rabies. The objectives of this study were (1) to assess community knowledge and attitudes about rabies, rabies prevention and stray dog control in an urban slum community and (2) to determine the factors that influence rabies awareness in urban slums. Using a systematic random sampling strategy, 185 participants were selected from 8 urban slums. The data were collected by direct interview using a pre-tested, structured questionnaire. In the study population, 74.1% of the participants had heard about rabies, and 54.1% knew that rabies is a fatal disease. Only 33.5% of the interviewees felt that people in the community had a role to play in controlling the stray dog population. Gender, age and educational status were significantly associated with rabies awareness. Our study indicates that there are gaps in the knowledge and attitudes of individuals living in urban slums regarding rabies prevention and control. Efforts to promote awareness should be targeted at men, older people and uneducated individuals. Copyright © 2012 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Understanding the urban-rural disparity in HIV and poverty nexus: the case of Kenya.

PubMed

Magadi, Monica A

2017-09-01

The relationship between HIV and poverty is complex and recent studies reveal an urban-rural divide that is not well understood. This paper examines the urban-rural disparity in the relationship between poverty and HIV infection in Kenya, with particular reference to possible explanations relating to social cohesion/capital and other moderating factors. Multilevel logistic regression models are applied to nationally-representative samples of 13 094 men and women of reproductive age from recent Kenya Demographic and Health Surveys. The results confirm a disproportionate higher risk of HIV infection among the urban poor, despite a general negative association between poverty and HIV infection among rural residents. Estimates of intra-community correlations suggest lower social cohesion in urban than rural communities. This, combined with marked socio-economic inequalities in urban areas is likely to result in the urban poor being particularly vulnerable. The results further reveal interesting cultural variations and trends. In particular, recent declines in HIV prevalence among urban residents in Kenya have been predominantly confined to those of higher socio-economic status. With current rapid urbanization patterns and increasing urban poverty, these trends have important implications for the future of the HIV epidemic in Kenya and similar settings across the sub-Saharan Africa region. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Urinary tract infection in infants caused by extended-spectrum beta-lactamase-producing Escherichia coli: comparison between urban and rural hospitals.

PubMed

Cheng, Ming-Fang; Chen, Wan-Ling; Huang, I-Fei; Chen, Jung-Ren; Chiou, Yee-Hsuan; Chen, Yao-Shen; Lee, Susan Shin-Jung; Hung, Wan-Yu; Hung, Chih-Hsin; Wang, Jiun-Ling

2016-08-01

Community-acquired urinary tract infection (UTI) caused by extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli is an emerging problem. Compared with urban infants, rural infants may encounter different distributions of community-acquired resistant strains and various barriers to efficient management. A retrospective survey and comparison was conducted for infants with UTI caused by ESBL-producing E. coli admitted to an urban hospital (n = 111) and a rural hospital (n = 48) in southern Taiwan from 2009 to 2012. Compared with 2009 and 2010, the total number of cases at both hospitals significantly increased in 2011 and 2012 (p < 0.001). Compared with the rural patients, the urban patients were significantly younger, and they had fewer days of fever before and after admission, fewer presentations of poor activity and poor appetite, and a lower serum creatinine level. Most of the patients had no prior history of illness, and we could not identify any significant different risk factors for acquiring ESBL-producing E. coli, such as past antimicrobial use, hospitalization, UTI, and underlying renal diseases, between the urban and rural populations. The increase in community-acquired UTI in infants caused by ESBL-producing E. coli was similar between the urban and rural populations. Our preliminary data suggest that the rural-urban disparities were probably related to easy access to health care by the urban population. ESBL complicates disease management, and the increase in the prevalence of ESBL producers is a major health concern and requires further healthy carrier and environmental surveillance.

75 FR 26768 - Office of Clinical and Preventive Services: Division of Behavioral Health Domestic Violence...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-05-12

... community programs critical places for identification and early intervention of abuse. Domestic violence is... physical and/or sexual IPV. The impact of domestic violence on women's reproductive health is pervasive and... community collaborations available in the urban AI/AN population in the United States. The DVPI aims to...

The Physical and Psychological Health of Migrants in Guangzhou, China

PubMed Central

Chen, Hongsheng; Zhu, Zhenjun; Sun, Dongqi; Wang, Xingping

2016-01-01

This study analyzed the health of migrants in 4 types of neighborhood in the city of Guangzhou in China. The research shows that the health of internal migrants in urban villages and private housing neighborhoods is much better than those living in older inner city neighborhoods (which are known as jiefang shequ) and unit neighborhoods (which are known as danwei). The reasons behind this are the facts that the migrants in urban villages tend to be relatively young and there tend to be better social and economic conditions in the private housing neighborhood. Moreover, among the 4 kinds of neighborhood, the gap between psychological health and physical health is the largest in urban villages. In addition, migrants who are younger, have better working conditions, and have higher levels of education have better health scores, and they tend to have more friends in the city, larger houses, better insurance, and more satisfaction with their neighborhood relationships, and they tend to be better adapted to urban life. As for the determinants of health, individual characteristics, community factors, and insurance are the most important factors. Specifically, individual age and age of housing have negative influences on physical health while insurance has a positive effect. This study shows that the type of neighborhood that migrants live in has a great impact on their psychological health, which can be improved by promoting neighborhood environments. Last, we propose that it is necessary to implement different strategies in different communities. PMID:27637270

Position of Social Determinants of Health in Urban Man-Made Lakes

PubMed Central

Shojaei, Parisa; Karimlou, Masoud; Mohammadi, Farahnaz; Afzali, Hosein Malek; Forouzan, Ameneh Setareh

2013-01-01

Background and Objective: A social determinants approach proposes that enhancing living conditions in areas such as income, housing, transportation, employment, education, social support, and health services is central to improving the health of urban populations. Urban development projects can be costly but have health impacts. The benefit derived from the creation of man-made lakes in developing countries is usually associated with great risks; however, the evidence for physical and non-physical health benefits of urban man-made lake is unclear. The aim of this paper is to formulate a conceptual framework of associations between urban man-made lakes and social determinants of health. Method: This study was a qualitative study carried out using one focus group discussion and 16 individual interviews. Data were analyzed based on deductive-inductive content analysis approach. Results: Participants’ points of view were analyzed within 261 codes. Data analysis matrix was the conceptual framework of social determinants of health commission and its sub-groups, thus, two structural and mediating determinants categories as well as their sub-sets were created accordingly. In addition, some extra sub-sets including environment, air quality, weather changes, noise pollution, pathogenesis, quality of life, shortage of available resources, region popularity, ethnicity, tourism, social and physical development of children, unintentional injuries, aesthetic, and spirituality were extracted beyond the matrix factors, which were placed in each of above categories based on their thematic content. Conclusion: This paper has illustrated that the quality and type of man-made lake provided within communities can have a significant and sustained impact on community’s health and wellbeing. Therefore, in order to strengthen positive effects and reduce negative effects of any developmental projects within community, their impacts on public health should be taken into consideration. PMID:24171878

Parenting Needs of Urban, African American Fathers.

PubMed

Smith, Tyler K; Tandon, S Darius; Bair-Merritt, Megan H; Hanson, Janice L

2015-07-01

Fathers play a critical role in children's development; similarly, fatherhood positively affects men's health. Among the larger population of fathers relatively little is known about the parenting knowledge of urban, African American fathers. Focusing on urban, African American fathers, the objectives of this study were to (1) understand the primary sources from which fathers learn about parenting, (2) determine where and how fathers prefer to receive future parenting education, and (3) explore the information perceived as most valuable to fathers and how this compares with the recommended anticipatory guidance (Bright Futures-based) delivered during well visits. Five focus groups, with a total of 21 participants, were conducted with urban fathers at a community-based organization. Study eligibility included being more than 18 years old, English speaking, and having at least one child 0 to 5 years old. During the focus groups, fathers were asked where they received parenting information, how and where they preferred to receive parenting information, and what they thought about Bright Futures parenting guidelines. Fathers most commonly described receiving parenting information from their own relatives rather than from their child's health care provider. Most fathers preferred to learn parenting from a person rather than a technology-based source and expressed interest in learning more about parenting at community-based locations. Although fathers viewed health care providers' role as primarily teaching about physical health, they valued Bright Futures anticipatory guidance about parenting. Fathers valued learning about child rearing, health, and development. Augmenting physician counseling about Bright Futures with community-based parenting education may be beneficial for fathers. © The Author(s) 2014.

Exposure to Community Violence and the Trajectory of Internalizing and Externalizing Symptoms in a Sample of Low-Income Urban Youth.

PubMed

Taylor, Jeremy J; Grant, Kathryn E; Zulauf, Courtney A; Fowler, Patrick J; Meyerson, David A; Irsheid, Sireen

2018-01-01

This study examined trajectories of psychopathology in a sample of low-income urban youth and tested exposure to community violence as a predictor of these trajectories. Self-report and parent-report survey measures of psychological problems and exposure to community violence were collected annually over 3 years from a sample of 364 fifth- to ninth-grade low-income urban youth (64% female; 95% youth of color). Linear growth models showed that youth experienced declines in both internalizing and externalizing symptoms across adolescence. Exposure to community violence was more strongly associated with externalizing symptoms than with internalizing symptoms but predicted declines in both types of symptoms. Results also indicated that youth reported more internalizing and externalizing symptoms than their parents reported for them. Exposure to community violence may explain unique trajectories of mental health problems among low-income urban youth. In addition, youth efforts to adopt a tough façade in the face of community violence could lead to higher rates of externalizing problems relative to internalizing problems, whereas desensitization processes may better explain reductions in both types of symptoms over time. Finally, youth report may be more valid than parent report in the context of urban poverty.

Understanding Social Isolation Among Urban Aging Adults: Informing Occupation-Based Approaches.

PubMed

Hand, Carri; Retrum, Jessica; Ware, George; Iwasaki, Patricia; Moaalii, Gabe; Main, Deborah S

2017-10-01

Socially isolated aging adults are at risk of poor health and well-being. Occupational therapy can help address this issue; however, information is needed to guide such work. National surveys characterize social isolation in populations of aging adults but fail to provide meaningful information at a community level. The objective of this study is to describe multiple dimensions of social isolation and related factors among aging adults in diverse urban neighborhoods. Community-based participatory research involving a door-to-door survey of adults 50 years and older was used. Participants ( N = 161) reported social isolation in terms of small social networks (24%) and wanting more social engagement (43%). Participants aged 50 to 64 years reported the highest levels of isolation in most dimensions. Low income, poor health, lack of transportation, and infrequent information access appeared linked to social isolation. Occupational therapists can address social isolation in similar urban communities through policy and practice that facilitate social engagement and network building.

‘Whose failure counts?’ A critical reflection on definitions of failure for community health volunteers providing HIV self-testing in a community-based HIV/TB intervention study in urban Malawi

PubMed Central

Sambakunsi, Rodrick; Kumwenda, Moses; Choko, Augustine; Corbett, Elizabeth L.; Desmond, Nicola Ann

2015-01-01

The category of community health worker applied within the context of health intervention trials has been promoted as a cost-effective approach to meeting study objectives across large populations, relying on the promotion of the concept of ‘com-munity belonging’ to encourage altruistic volunteerism from community members to promote health. This community-based category of individuals is recruited to facilitate externally driven priorities defined by large research teams, outside of the target research environment. An externally defined intervention is then ‘brought to’ the community through locally recruited community volunteers who form a bridge between the researchers and participants. The specific role of these workers is context-driven and responsive to the needs of the intervention. This paper is based on the findings from an annual evaluation of community health worker performance employed as community counsellors to deliver semi-supervised HIV self-testing (HIVST) at community level of a large HIV/TB intervention trial conducted in urban Blantyre, Malawi. A performance evaluation was conducted to appraise individual service delivery and assess achievements in meeting pre-defined targets for uptake of HIVST with the aim of improving overall uptake of HIVST. Through an empirical ‘evaluation of the evaluation’ this paper critically reflects on the position of the community volunteer through the analytical lens of ‘failure’, exploring the tensions in communication and interpretation of intervention delivery between researchers and community volunteers and the differing perspectives on defining failure. It is concluded that community interventions should be developed in collaboration with the population and that information guiding success should be clearly defined. PMID:26762610

Adolescents' perceptions of health from disadvantaged urban communities: findings from the WAVE study.

PubMed

Mmari, Kristin; Blum, Robert; Sonenstein, Freya; Marshall, Beth; Brahmbhatt, Heena; Venables, Emily; Delany-Moretlwe, Sinead; Lou, Chaohua; Gao, Ershang; Acharya, Rajib; Jejeebhoy, Shireen; Sangowawa, Adesola

2014-03-01

The Well-being of Adolescents in Vulnerable Environments (WAVE) is a global study of young people living in disadvantaged urban communities from Baltimore, MD, Johannesburg, South Africa, Shanghai, China, New Delhi, India and Ibadan, Nigeria. WAVE was launched in the summer of 2011 to: 1) explore adolescents' perceived health and their top health challenges; and 2) describe the factors that adolescents perceive to be related to their health and health care utilization. Researchers in each site conducted in-depth interviews among adolescents; community mapping and focus groups among adolescents; a Photovoice methodology, in which adolescents were trained in photography and took photos of the meaning of 'health' in their communities; and key informant interviews among adults who work with young people. A total 529 participants from across the sites were included in the analysis. Findings from the study showed that gender played a large role with regards to what adolescents considered as their top health challenges. Among females, sexual and reproductive health problems were primary health challenges, whereas among males, tobacco, drug, and alcohol consumption was of highest concern, which often resulted into acts of violence. Personal safety was also a top concern among males and females from Baltimore and Johannesburg, and among females in New Delhi and Ibadan. Factors perceived to influence health the most were the physical environment, which was characterized by inadequate sanitation and over-crowded buildings, and the social environment, which varied in influence by gender and site. Regardless of the study site, adolescents did not consider physical health as a top priority and very few felt the need to seek health care services. This study highlights the need to focus on underlying structural and social factors for promoting health and well-being among adolescents in disadvantaged urban environments. Copyright © 2013 Elsevier Ltd. All rights reserved.

COMMUNITY STRESSORS AND SUSCEPTIBILITY TO AIR POLLUTION IN URBAN ASTHMA

EPA Science Inventory

Given our large sample size within and across communities, our unique data on year-round fine-scale variability in multiple air pollutants, and our strong experience in community –based environmental health education and outreach, we believe that our study will provid...

Can urban regeneration programmes assist coping and recovery for people with mental illness? Suggestions from a qualitative case study.

PubMed

Whitley, Rob; Prince, Martin

2006-03-01

Researchers and policy-makers are increasingly recognizing that urban socio-environmental conditions can affect the development and course of numerous health problems. The aim of this paper is to investigate the impact an urban regeneration programme can have on everyday functioning, coping and recovery for people with a mental illness. We were also interested in discerning which component parts of the regeneration are the most important in positively affecting people with mental illness. These questions were explored through an in-depth qualitative case study of the Gospel Oak neighbourhood in London, which recently underwent an intensive urban regeneration programme. Interviews and focus groups were conducted with residents living with a mental illness (n = 16). Relevant participant observation was also conducted. Participants reported that interventions that improved community safety were by far the most important in affecting everyday coping and functioning. Interventions that improved the quantity and quality of shared community facilities had a positive, but milder effect on mental health. Component parts that appeared to have little effect included environmental landscaping and greater community involvement in decision-making processes. Most participants reported that their mental illness was a consequence of severe insults over the life-span, for example childhood neglect or family breakdown. Thus, the regeneration was seen as something that could assist coping, but not something that could significantly contribute to complete recovery. Our results thus suggest that urban regeneration can have a mild impact on people with mental illness, but this appears to be outweighed by life-span experience of severe individual-level risk factors. That said, some of our findings converge with other studies indicating that community safety and community facilities can play a role in positively affecting mental health. Further ethnographic and epidemiological research is necessary to explore these two factors.

Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

PubMed

Malewski, David F; Ream, Aimrie; Gaither, Caroline A

2015-01-01

Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

A study on the factors influencing the community participation of older adults in China: based on the CHARLS2011 data set.

PubMed

Lin, Wenyi

2017-05-01

Many communities provide older people with various opportunities to participate in the society. The 2010 Chinese census reveals that the majority of the older adults in China are still healthy, but research shows that older adults have relatively low levels of community participation. This study aims to determine the factors that affect the community participation of older adults in China using data collected from the 2011 China Health and Retirement Longitudinal Study (CHARLS). The CHARLS survey used a multistage sampling strategy to select respondents from 450 resident or village communities in China. A total of 17,000 persons from 10,000 families participated in the survey. The sample for this study includes 4283 individuals aged 60 years and above who have been invited to answer the survey based on their participation in entertainment and volunteer activities within the past month; 1009 were from urban areas and 3247 were from rural areas. Using logistic regression, this study identifies several variables that can predict the community participation of older adults. These variables included educational background, residence status, self-rated living standard and health status, number of available community facilities, expected social support, family care responsibility and involvement/non-involvement in old-age insurance schemes. In addition, an urban-rural difference was observed in the participation of these adults in entertainment activities, and the differences between older adults residing in urban and rural areas were insignificant in terms of their participation in volunteer work. These findings imply that the Chinese government should consider these predictors and the urban-rural differences when making policies regarding the community participation of older adults. © 2017 John Wiley & Sons Ltd.

Maternal and child under-nutrition in rural and urban communities of Lagos state, Nigeria: the relationship and risk factors

PubMed Central

2013-01-01

Background Poor nutritional status of mothers has a direct and indirect consequence on their own health and that of their children. The objective of this study was to determine the relationship between nutritional status of mothers and their children and the risk factors for under-nutrition among mothers and children in rural and urban communities of Lagos State, Nigeria. Methods This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Under-nutrition in mothers and children was determined using standard criteria. Results The prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%, p = 0.014). The prevalences of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%, p < 0.001) and (43.3% vs. 12.6%, p < 0.001) respectively. In rural communities, the risk of stunted mothers having children with stunting was about 7 times higher than those who were not (OR 6.7, 95% CI = 1.4-32.0, p = 0.007). In urban communities, undernourished mothers have about 11 and 12 times risk of having children with underweight and wasting respectively (OR 11.2, 95% CI = 1.4-86.5, p = 0.005) and (OR 12.3, 95% CI = 1.6-95.7, p = 0.003) respectively. The identified risk factors for maternal and child under nutrition differs across rural and urban communities. Conclusions The prevalence of maternal and child under-nutrition is high in both communities although higher in rural communities. Efforts at reducing the vicious cycle of under-nutrition among mothers and children should concentrate on addressing risk factors specific for each community. PMID:23880121

Maternal and child under-nutrition in rural and urban communities of Lagos state, Nigeria: the relationship and risk factors.

PubMed

Senbanjo, Idowu O; Olayiwola, Ibiyemi O; Afolabi, Wasiu A; Senbanjo, Olayinka C

2013-07-23

Poor nutritional status of mothers has a direct and indirect consequence on their own health and that of their children. The objective of this study was to determine the relationship between nutritional status of mothers and their children and the risk factors for under-nutrition among mothers and children in rural and urban communities of Lagos State, Nigeria. This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Under-nutrition in mothers and children was determined using standard criteria. The prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%, p = 0.014). The prevalences of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%, p < 0.001) and (43.3% vs. 12.6%, p < 0.001) respectively. In rural communities, the risk of stunted mothers having children with stunting was about 7 times higher than those who were not (OR 6.7, 95% CI = 1.4-32.0, p = 0.007). In urban communities, undernourished mothers have about 11 and 12 times risk of having children with underweight and wasting respectively (OR 11.2, 95% CI = 1.4-86.5, p = 0.005) and (OR 12.3, 95% CI = 1.6-95.7, p = 0.003) respectively. The identified risk factors for maternal and child under nutrition differs across rural and urban communities. The prevalence of maternal and child under-nutrition is high in both communities although higher in rural communities. Efforts at reducing the vicious cycle of under-nutrition among mothers and children should concentrate on addressing risk factors specific for each community.

Perspectives on enhancing physical activity and diet for health promotion among at-risk urban UK South Asian communities: a qualitative study.

PubMed

Cross-Bardell, Laura; George, Tracey; Bhoday, Mandeep; Tuomainen, Helena; Qureshi, Nadeem; Kai, Joe

2015-02-27

To explore perspectives on enhancing physical activity and diet among South Asians in urban deprived communities at high risk of chronic disease and to inform development of culturally appropriate health promotion intervention. Qualitative study using semistructured one-to-one and family group interviews with thematic analysis of data. Urban disadvantaged communities in the East Midlands of the UK. 45 respondents, including 34 people of South Asian origin (16 at-risk individuals, six family groups involving 18 relatives), of mainly Pakistani and Indian origin, including 16 non-English speakers; and 11 health professionals working locally with communities of concern. South Asian participants underlined the challenges of requiring family members across generations to engage in modifying dietary behaviours, and the central role of communal eating of traditional 'Asian' food in their cultural lives. Barriers to increasing physical activity included cost, personal safety and lack of time outside of long working hours and carer commitments. However, increasing walking activity was regarded as feasible by both community and health professional participants. Respondents emphasised using a social approach for potential interventions, undertaking activity with family or friends and with bilingual community peers to facilitate engagement, motivation and support. Spoken content and delivery of interventions was favoured, including personal stories and multilingual audio-visual information; within local informal rather than provider settings, including the home; and aided by pedometers for self-monitoring. Focusing on physical activity by increasing walking may hold promise as health promotion in this deprived South Asian community context. Further intervention development, with exploration of feasibility and acceptability of the social approach and elements suggested, is merited. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

G3 Program

EPA Pesticide Factsheets

The G3 initiative was designed to build a collaborative network for small to mid-sized towns and communities that are interested in adopting Green Streets to address urban stormwater, improve community health and livability, and encourage economic growth.

Urban Green Space and Its Impact on Human Health

PubMed Central

Kondo, Michelle C.; Fluehr, Jaime M.; McKeon, Thomas; Branas, Charles C.

2018-01-01

Background: Over half of the world’s population now lives in urban areas, and this proportion is expected to increase. While there have been numerous reviews of empirical studies on the link between nature and human health, very few have focused on the urban context, and most have examined almost exclusively cross-sectional research. This review is a first step toward assessing the possibility of causal relationships between nature and health in urban settings. Methods: Through systematic review of published literature, we explored the association between urban green space and human health. Results: We found consistent negative association between urban green space exposure and mortality, heart rate, and violence, and positive association with attention, mood, and physical activity. Results were mixed, or no association was found, in studies of urban green space exposure and general health, weight status, depression, and stress (via cortisol concentration). The number of studies was too low to generalize about birth outcomes, blood pressure, heart rate variability, cancer, diabetes, or respiratory symptoms. Conclusions: More studies using rigorous study design are needed to make generalizations, and meta-analyses, of these and other health outcomes possible. These findings may assist urban managers, organizations, and communities in their efforts to increase new or preserve existing green space. PMID:29510520

COACH trial: A randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: Rationale and design

PubMed Central

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-01-01

Background Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. Methods The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. Results A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. Conclusions This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. PMID:21241828

COACH trial: a randomized controlled trial of nurse practitioner/community health worker cardiovascular disease risk reduction in urban community health centers: rationale and design.

PubMed

Allen, Jerilyn K; Himmelfarb, Cheryl R Dennison; Szanton, Sarah L; Bone, Lee; Hill, Martha N; Levine, David M

2011-05-01

Despite well-publicized guidelines on the appropriate management of cardiovascular disease (CVD) and type 2 diabetes, implementation of risk-reducing practices remains poor. This paper describes the rationale and design of a randomized controlled clinical trial evaluating the effectiveness of a comprehensive program of CVD risk reduction delivered by nurse practitioner (NP)/community health worker (CHW) teams versus enhanced usual care in improving the proportion of patients in urban community health centers who achieve goal levels recommended by national guidelines for lipids, blood pressure, HbA1c and prescription of appropriate medications. The COACH (Community Outreach and Cardiovascular Health) trial is a randomized controlled trial in which patients at federally-qualified community health centers were randomly assigned to one of two groups: comprehensive intensive management of CVD risk factors for one year by a NP/CHW team or an enhanced usual care control group. A total of 3899 patients were assessed for eligibility and 525 were randomized. Groups were comparable at baseline on sociodemographic and clinical characteristics with the exception of statistically significant differences in total cholesterol and hemoglobin A1c. This study is a novel amalgam of multilevel interdisciplinary strategies to translate highly efficacious therapies to low-income federally-funded health centers that care for patients who carry a disproportionate burden of CVD, type 2 diabetes and uncontrolled CVD risk factors. The impact of such a community clinic-based intervention is potentially enormous. Copyright © 2011 Elsevier Inc. All rights reserved.

An Interactive and Contextual Model of Community-University Collaborations for Research and Action

ERIC Educational Resources Information Center

Suarez-Balcazar, Yolanda; Harper, Gary W.; Lewis, Rhonda

2005-01-01

Community-university partnerships for research and action are at the heart of many fields in the social sciences including public health, urban planning, education, and community psychology. These partnerships involve individuals from different backgrounds and disciplines working together to address social issues of importance to the community.…

Social Aspects of Urban Forestry: the Role of Arboriculture in a Healthy Social Ecology

Treesearch

Frances E. Kuo

2003-01-01

In urban communities, arboriculture clearly contributes to the health of the biological ecosystem; does it contribute to the health of the social ecosystem as well? Evidence from studies in inner-city Chicago suggests so. In a series of studies involving over 1,300 person-space observations, 400 interviews, housing authority records, and 2 years of police crime reports...

Urban-rural disparity and determinants of delivery care utilization in Oromia region, Ethiopia: Community-based cross-sectional study.

PubMed

Kenea, Dinke; Jisha, Hunduma

2017-02-01

Low delivery care utilization continues to be a public health problem that significantly contributes to maternal morbidity and mortality, especially in developing countries like Ethiopia. The aim of the study is to determine the extent of urban-rural disparity of delivery care utilization and its determinants. A community-based cross-sectional quantitative study supplemented with qualitative data was conducted from February 15 to March 10, 2014. Data were collected from eligible woman using interviewer-guided semistructured questionnaires and focus group discussions. Logistic regression analysis with 95% confidence interval and p-value less than 5% was used to identify potential determinant variables. From 567 women, institutional delivery care was attended by 45.9% (260) respondents of whom 69.3% were urban and 21.3% were rural. Mass media and antenatal care attendance were the major determinants in urban respondents, whereas children ever born, partners' occupation, women's autonomy, and pregnancy-related health problems were statistically significant associations in rural women. The need for maternal health care is not met to the required level. There is a significant disparity in delivery care attendance among urban and rural women of the study area. Women's empowerment and awareness creation should be extensively worked on through mass media and posters or health information. © 2017 John Wiley & Sons Australia, Ltd.

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States.

PubMed

Caldwell, Julia T; Ford, Chandra L; Wallace, Steven P; Wang, May C; Takahashi, Lois M

2016-08-01

To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. We linked Medical Expenditure Panel Survey (2005-2010) data to geographic data from the American Community Survey (2005-2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural-Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply.

Point-of-Sale Tobacco Marketing in Rural and Urban Ohio: Could the New Landscape of Tobacco Products Widen Inequalities?

PubMed Central

Roberts, Megan E.; Berman, Micah L.; Slater, Michael D.; Hinton, Alice; Ferketich, Amy K.

2015-01-01

Considerable research has examined how cigarette point-of-sale advertising is closely related to smoking-related disparities across communities. Yet few studies have examined marketing of alternative tobacco products (e.g., e-cigarettes). The goal of the present study was to examine external point-of-sale marketing of various tobacco products and determine its association with community-level demographics (population density, economic-disadvantage, race/ethnicity) in urban and rural regions of Ohio. During the summer of 2014, fieldworkers collected comprehensive tobacco marketing data from 199 stores in Ohio (99 in Appalachia, 100 in Columbus), including information on external features. The address of each store was geocoded to its census tract, providing information about the community in which the store was located. Results indicated that promotions for e-cigarettes and advertising for menthol cigarettes, cigarillos, and cigars were more prevalent in communities with a higher percentage of African Americans. Cigarillos advertising was more likely in high-disadvantage and urban communities. A greater variety of products were also advertised outside retailers in urban, high-disadvantage, African American communities. Findings provide evidence of differential tobacco marketing at the external point-of-sale, which disproportionately targets urban, economically-disadvantaged, and African American communities. There is a need for tobacco control policies that will help improve equity and reduce health disparities. PMID:26363447

Point-of-sale tobacco marketing in rural and urban Ohio: Could the new landscape of Tobacco products widen inequalities?

PubMed

Roberts, Megan E; Berman, Micah L; Slater, Michael D; Hinton, Alice; Ferketich, Amy K

2015-12-01

Considerable research has examined how cigarette point-of-sale advertising is closely related to smoking-related disparities across communities. Yet few studies have examined marketing of alternative tobacco products (e.g., e-cigarettes). The goal of the present study was to examine external point-of-sale marketing of various tobacco products and determine its association with community-level demographics (population density, economic-disadvantage, race/ethnicity) in urban and rural regions of Ohio. During the summer of 2014, fieldworkers collected comprehensive tobacco marketing data from 199 stores in Ohio (99 in Appalachia, 100 in Columbus), including information on external features. The address of each store was geocoded to its census tract, providing information about the community in which the store was located. Results indicated that promotions for e-cigarettes and advertising for menthol cigarettes, cigarillos, and cigars were more prevalent in communities with a higher percentage of African Americans. Cigarillos advertising was more likely in high-disadvantage and urban communities. A greater variety of products were also advertised outside retailers in urban, high-disadvantage, African American communities. Findings provide evidence of differential tobacco marketing at the external point-of-sale, which disproportionately targets urban, economically-disadvantaged, and African American communities. There is a need for tobacco control policies that will help improve equity and reduce health disparities. Copyright © 2015 Elsevier Inc. All rights reserved.

The Changing Context of Rural America: A Call to Examine the Impact of Social Change on Mental Health and Mental Health Care.

PubMed

Carpenter-Song, Elizabeth; Snell-Rood, Claire

2017-05-01

Recent social changes and rising social inequality in the rural United States have affected the experience and meaning of mental illness and treatment seeking within rural communities. Rural Americans face serious mental health disparities, including higher rates of suicide and depression compared with residents of urban areas, and substance abuse rates in rural areas now equal those in urban areas. Despite these increased risks, people living in rural areas are less likely than their urban counterparts to seek or receive mental health services. This Open Forum calls for a research agenda supported by anthropological theory and methods to investigate the significance of this changed rural social context for mental health.

Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

PubMed Central

2010-01-01

Background It is important that community-based health insurance (CBHI) schemes are designed in such a way as to ensure the relevance of the benefit packages to potential clients. Hence, this paper provides an understanding of the preferred benefit packages by different economic status groups as well as urban and rural dwellers for CBHI in Southeast Nigeria. Methods The study took place in rural, urban and semi-urban communities of south-east Nigeria. A questionnaire was used to collect information from 3070 randomly picked household heads. Focus group discussions were used to collect qualitative data. Data was examined for links between preferences for benefit packages with SES and geographic residence of the respondents. Results Respondents in the rural areas and in the lower SES preferred a comprehensive benefit package which includes all inpatient, outpatient and emergencies services, while those in urban areas as well as those in the higher SES group showed a preference for benefit packages which will cover only basic disease control interventions. Conclusion Equity concerns in preferences for services to be offered by the CBHI scheme should be addressed for CBHI to succeed in different contexts. PMID:20540787

Food beliefs and practices in urban poor communities in Accra: implications for health interventions.

PubMed

Boatemaa, Sandra; Badasu, Delali Margaret; de-Graft Aikins, Ama

2018-04-02

Poor communities in low and middle income countries are reported to experience a higher burden of chronic non-communicable diseases (NCDs) and nutrition-related NCDs. Interventions that build on lay perspectives of risk are recommended. The objective of this study was to examine lay understanding of healthy and unhealthy food practices, factors that influence food choices and the implications for developing population health interventions in three urban poor communities in Accra, Ghana. Thirty lay adults were recruited and interviewed in two poor urban communities in Accra. The interviews were audio-taped, transcribed and analysed thematically. The analysis was guided by the socio-ecological model which focuses on the intrapersonal, interpersonal, community, structural and policy levels of social organisation. Food was perceived as an edible natural resource, and healthy in its raw state. A food item retained its natural, healthy properties or became unhealthy depending on how it was prepared (e.g. frying vs boiling) and consumed (e.g. early or late in the day). These food beliefs reflected broader social food norms in the community and incorporated ideas aligned with standard expert dietary guidelines. Healthy cooking was perceived as the ability to select good ingredients, use appropriate cooking methods, and maintain food hygiene. Healthy eating was defined in three ways: 1) eating the right meals; 2) eating the right quantity; and 3) eating at the right time. Factors that influenced food choice included finances, physical and psychological state, significant others and community resources. The findings suggest that beliefs about healthy and unhealthy food practices are rooted in multi-level factors, including individual experience, family dynamics and community factors. The factors influencing food choices are also multilevel. The implications of the findings for the design and content of dietary and health interventions are discussed.

Impacts of rapid urbanization on the water quality and macroinvertebrate communities of streams: A case study in Liangjiang New Area, China.

PubMed

Luo, Kun; Hu, Xuebin; He, Qiang; Wu, Zhengsong; Cheng, Hao; Hu, Zhenlong; Mazumder, Asit

2018-04-15

Rapid urbanization in China has dramatically deteriorated the water quality of streams and threatening aquatic ecosystem health. This study aims to 1) assess the impacts of urbanization on water quality and macroinvertebrate composition and 2) address the question of how urbanization affects macroinvertebrate distribution patterns. Environmental variables over multispatial scales and macroinvertebrate community data were collected on April (dry season) and September (wet season) of 2014 and 2015 at 19 sampling sites, of which nine had a high urbanization level (HUL), six had moderate urbanization level (MUL) and four had low urbanization level (LUL), in the Liangjiang New Area. The results of this study showed that macroinvertebrate assemblages significantly varied across the three urbanization levels. The sensitive species (e.g., EPT taxa) were mainly centralized at LUL sites, whereas tolerant species, such as Tubificidae (17.3%), Chironomidae (12.1%), and Physidae (4.61%), reached highest relative abundance at LUL sites. The values of family biotic index (FBI) and biological monitoring working party (BMWP) indicated the deterioration of water quality along urbanization gradient. Seasonal and inter - annual changes in macroinvertebrate communities were not observed. The results of variation partitioning analyses (CCAs) showed that habitat scale variables explained the major variation in macroinvertebrate community composition. Specifically, the increased nutrient concentrations favored tolerant species, whereas high water flow and substrate coarseness benefitted community taxa richness, diversity and EPT richness. Considering the interactions between scale-related processes, the results of this study suggested that urbanization resulted in less diverse and more tolerant stream macroinvertebrate assemblages mainly via increased nutrient concentrations and reduced substrate coarseness. Copyright © 2017 Elsevier B.V. All rights reserved.

Ectomycorrhizal Fungal Communities in Urban Parks Are Similar to Those in Natural Forests but Shaped by Vegetation and Park Age.

PubMed

Hui, Nan; Liu, Xinxin; Kotze, D Johan; Jumpponen, Ari; Francini, Gaia; Setälä, Heikki

2017-12-01

Ectomycorrhizal (ECM) fungi are important mutualists for the growth and health of most boreal trees. Forest age and its host species composition can impact the composition of ECM fungal communities. Although plentiful empirical data exist for forested environments, the effects of established vegetation and its successional trajectories on ECM fungi in urban greenspaces remain poorly understood. We analyzed ECM fungi in 5 control forests and 41 urban parks of two plant functional groups (conifer and broadleaf trees) and in three age categories (10, ∼50, and >100 years old) in southern Finland. Our results show that although ECM fungal richness was marginally greater in forests than in urban parks, urban parks still hosted rich and diverse ECM fungal communities. ECM fungal community composition differed between the two habitats but was driven by taxon rank order reordering, as key ECM fungal taxa remained largely the same. In parks, the ECM communities differed between conifer and broadleaf trees. The successional trajectories of ECM fungi, as inferred in relation to the time since park construction, differed among the conifers and broadleaf trees: the ECM fungal communities changed over time under the conifers, whereas communities under broadleaf trees provided no evidence for such age-related effects. Our data show that plant-ECM fungus interactions in urban parks, in spite of being constructed environments, are surprisingly similar in richness to those in natural forests. This suggests that the presence of host trees, rather than soil characteristics or even disturbance regime of the system, determine ECM fungal community structure and diversity. IMPORTANCE In urban environments, soil and trees improve environmental quality and provide essential ecosystem services. ECM fungi enhance plant growth and performance, increasing plant nutrient acquisition and protecting plants against toxic compounds. Recent evidence indicates that soil-inhabiting fungal communities, including ECM and saprotrophic fungi, in urban parks are affected by plant functional type and park age. However, ECM fungal diversity and its responses to urban stress, plant functional type, or park age remain unknown. The significance of our study is in identifying, in greater detail, the responses of ECM fungi in the rhizospheres of conifer and broadleaf trees in urban parks. This will greatly enhance our knowledge of ECM fungal communities under urban stresses, and the findings can be utilized by urban planners to improve urban ecosystem services. Copyright © 2017 American Society for Microbiology.

Urban air pollution and health inequities: a workshop report.

PubMed

2001-06-01

Over the past three decades, an array of legislation with attendant regulations has been implemented to enhance the quality of the environment and thereby improve the public's health. Despite the many beneficial changes that have followed, there remains a disproportionately higher prevalence of harmful environmental exposures, particularly air pollution, for certain populations. These populations most often reside in urban settings, have low socioeconomic status, and include a large proportion of ethnic minorities. The disparities between racial/ethnic minority and/or low-income populations in cities and the general population in terms of environmental exposures and related health risks have prompted the "environmental justice" or "environmental equity" movement, which strives to create cleaner environments for the most polluted communities. Achieving cleaner environments will require interventions based on scientific data specific to the populations at risk; however, research in this area has been relatively limited. To assess the current scientific information on urban air pollution and its health impacts and to help set the agenda for immediate intervention and future research, the American Lung Association organized an invited workshop on Urban Air Pollution and Health Inequities held 22-24 October 1999 in Washington, DC. This report builds on literature reviews and summarizes the discussions of working groups charged with addressing key areas relevant to air pollution and health effects in urban environments. An overview was provided of the state of the science for health impacts of air pollution and technologies available for air quality monitoring and exposure assessment. The working groups then prioritized research needs to address the knowledge gaps and developed recommendations for community interventions and public policy to begin to remedy the exposure and health inequities.

Urban air pollution and health inequities: a workshop report.

PubMed Central

2001-01-01

Over the past three decades, an array of legislation with attendant regulations has been implemented to enhance the quality of the environment and thereby improve the public's health. Despite the many beneficial changes that have followed, there remains a disproportionately higher prevalence of harmful environmental exposures, particularly air pollution, for certain populations. These populations most often reside in urban settings, have low socioeconomic status, and include a large proportion of ethnic minorities. The disparities between racial/ethnic minority and/or low-income populations in cities and the general population in terms of environmental exposures and related health risks have prompted the "environmental justice" or "environmental equity" movement, which strives to create cleaner environments for the most polluted communities. Achieving cleaner environments will require interventions based on scientific data specific to the populations at risk; however, research in this area has been relatively limited. To assess the current scientific information on urban air pollution and its health impacts and to help set the agenda for immediate intervention and future research, the American Lung Association organized an invited workshop on Urban Air Pollution and Health Inequities held 22-24 October 1999 in Washington, DC. This report builds on literature reviews and summarizes the discussions of working groups charged with addressing key areas relevant to air pollution and health effects in urban environments. An overview was provided of the state of the science for health impacts of air pollution and technologies available for air quality monitoring and exposure assessment. The working groups then prioritized research needs to address the knowledge gaps and developed recommendations for community interventions and public policy to begin to remedy the exposure and health inequities. PMID:11427385

Service Learning: A Vehicle for Building Health Equity and Eliminating Health Disparities

PubMed Central

Sabo, Samantha; de Zapien, Jill; Teufel-Shone, Nicolette; Rosales, Cecilia; Bergsma, Lynda

2015-01-01

Service learning (SL) is a form of community-centered experiential education that places emerging health professionals in community-generated service projects and provides structured opportunities for reflection on the broader social, economic, and political contexts of health. We describe the elements and impact of five distinct week-long intensive SL courses focused on the context of urban, rural, border, and indigenous health contexts. Students involved in these SL courses demonstrated a commitment to community-engaged scholarship and practice in both their student and professional lives. SL is directly in line with the core public health value of social justice and serves as a venue to strengthen community–campus partnerships in addressing health disparities through sustained collaboration and action in vulnerable communities. PMID:25706014

The concrete jungle: city stress and substance abuse among young adult African American men.

PubMed

Seth, Puja; Murray, Colleen C; Braxton, Nikia D; DiClemente, Ralph J

2013-04-01

Substance use is prevalent among African American men living in urban communities. The impact of substance use on the social, psychological, and physical health of African American men has important public health implications for families, communities, and society. Given the adverse consequences of alcohol and drug abuse within communities of color, this study evaluated the relationship between city stress, alcohol consumption, and drug use among African American men. Eighty heterosexual, African American men, 18 to 29 years old, completed psychosocial risk assessments that assessed substance use and city stress. Multiple logistic regression analyses, controlling for age, indicated that participants reporting high levels of urban stress, relative to low levels of urban stress, were more likely to report a history of marijuana use (AOR = 5.19, p = .05), history of ecstasy and/or GHB use (AOR = 3.34, p = .04), having family/friends expressing strong concerns about their illicit drug use (AOR = 4.06, p = .02), and being unable to remember what happened the night before due to drinking (AOR = 4.98, p = .01). African American men living within the confines of a stressful urban environment are at increased risk for exposure to and utilization of illicit substances. Culturally competent public health interventions for substance use/abuse should address psychological factors, such as stress and neighborhood violence.

Memoryscape

Treesearch

Lindsay Campbell

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Segregation and Disparities in Health Services Use

PubMed Central

Gaskin, Darrell J.; Price, Adrian; Brandon, Dwayne T.; LaVeist, Thomas A.

2011-01-01

We compared race disparities in health services use in a national sample of adults from the 2002 Medical Expenditure Panel Survey and data from the Exploring Health Disparities in Integrated Communities Project, a 2003 survey of adult residents from a low-income integrated urban community in Maryland. In the Medical Expenditure Panel Survey data, African Americans were less likely to have a health care visit compared with Whites. However, in the Exploring Health Disparities in Integrated Communities Project, the integrated community, African Americans were more likely to have a health care visit than Whites. The race disparities in the incidence rate of health care use among persons who had at least one visit were similar in both samples. Our findings suggest that disparities in health care utilization may differ across communities and that residential segregation may be a confounding factor. PMID:19460811

Air pollution, economic development of communities, and health status among the elderly in urban China.

PubMed

Sun, Rongjun; Gu, Danan

2008-12-01

In Western societies, the impact of air pollution on residents' health is higher in less wealthy communities. However, it is not clear whether such an interaction effect applies to developing countries. The authors examine how the level of community development modifies the impact of air pollution on health outcomes of the Chinese elderly using data from the third wave of the Chinese Longitudinal Health Longevity Survey in 2002, which includes 7,358 elderly residents aged 65 or more years from 735 districts in 171 cities. The results show that, compared with a 1-point increase in the air pollution index in urban areas with a low gross domestic product, a similar increase in the air pollution index in areas with a high gross domestic product is associated with more difficulties in activities of daily living (odds ratio = 1.41, 95% confidence interval (CI): 1.09, 1.83), instrumental activities of daily living (linear coefficient = 0.98, 95% CI: 0.58, 1.37), and cognitive function (linear coefficient = 2.67, 95% CI: 1.97, 3.36), as well as a higher level of self-rated poor health (odds ratio = 2.20, 95% CI: 1.68, 2.86). Contrary to what has been found in the West, Chinese elderly who live in more developed urban areas are more susceptible to the effect of air pollution than are their counterparts living in less developed areas.

Producing "science/fictions" about the rural and urban poor: Community-based learning at a medical college in South India

NASA Astrophysics Data System (ADS)

Arur, Aditi Ashok

This dissertation is an ethnographic case study of a community-based teaching program (CBTP) in public health at a medical college in South India that explored how the CBTP produced particular ways of seeing and understanding rural and urban poor communities. Drawing from critical, feminist, and postcolonial scholars, I suggest that the knowledge produced in the CBTP can be understood as "science/fictions", that is, as cultural texts shaped by transnational development discourses as well as medical teachers' and students' sociospatial imaginations of the rural and urban poor. I explored how these science/fictions mediated medical students' performative actions and interactions with a rural and an urban poor community in the context of the CBTP. At the same time, I also examined how knowledge produced in students' encounters with these communities disrupted their naturalized understandings about these communities, and how it was taken up to renarrativize science/fictions anew. Data collection and analyses procedures were informed by critical ethnographic and critical discourse analysis approaches. Data sources includes field notes constructed from observations of the CBTP, interviews with medical teachers and students, and curricular texts including the standardized national textbook of public health. The findings of this study illustrate how the CBTP staged the government and technology as central actors in the production of healthy bodies, communities, and environments, and implicitly positioned medical teachers and students as productive citizens of a modern nation while rural and urban poor communities were characterized sometimes as empowered, and at other times as not-yet-modern and in need of reform. However, the community also constituted an alternate pedagogical site of engagement in that students' encounters with community members disrupted students' assumptions about these communities to an extent. Nevertheless, institutionalized practices of assessment, and epistemological and ontological understandings of the nature of science tended to privilege the standardized curriculum and popular cultural stereotypes as scientific knowledge thereby excluding the place-based narratives of local communities, medical students, and teachers. This study, therefore, argues that interactions with local communities in community-based education and development programs cannot democratize knowledge production in medical education without a simultaneous engagement with post-foundational epistemologies in the social sciences and humanities.

Physical activity and the rejuvenation of Connswater (PARC study): protocol for a natural experiment investigating the impact of urban regeneration on public health

PubMed Central

2013-01-01

Background There is a dearth of evidence regarding the impact of urban regeneration projects on public health, particularly the nature and degree to which urban regeneration impacts upon health-related behaviour change. Natural experiment methodology enables comprehensive large-scale evaluations of such interventions. The Connswater Community Greenway in Belfast is a major urban regeneration project involving the development of a 9 km linear park, including the provision of new cycle paths and walkways. In addition to the environmental improvements, this complex intervention involves a number of programmes to promote physical activity in the regenerated area. The project affords a unique opportunity to investigate the public health impact of urban regeneration. Methods/Design The evaluation framework was informed by the socio-ecological model and guided by the RE-AIM Framework. Key components include: (1) a quasi-experimental before-and-after survey of the Greenway population (repeated cross-sectional design), in tandem with data from a parallel Northern Ireland-wide survey for comparison; (2) an assessment of changes in the local built environment and of walkability using geographic information systems; (3) semi-structured interviews with a purposive sample of survey respondents, and a range of community stakeholders, before and after the regeneration project; and (4) a cost-effectiveness analysis. The primary outcome is change in proportion of individuals identified as being regularly physically active, according to the current UK recommendations. The RE-AIM Framework will be used to make an overall assessment of the impact of the Greenway on the physical activity behaviour of local residents. Discussion The Connswater Community Greenway provides a significant opportunity to achieve long-term, population level behaviour change. We argue that urban regeneration may be conceptualised meaningfully as a complex intervention comprising multiple components with the potential, individually and interactively, to affect the behaviour of a diverse population. The development and implementation of our comprehensive evaluation framework reflects this complexity and illuminates an approach to the empirical, rigorous evaluation of urban regeneration. More specifically, this study will add to the much needed evidence-base about the impact of urban regeneration on public health as well as having important implications for the development of natural experiment methodology. PMID:24103381

Physical activity and the rejuvenation of Connswater (PARC study): protocol for a natural experiment investigating the impact of urban regeneration on public health.

PubMed

Tully, Mark A; Hunter, Ruth F; McAneney, Helen; Cupples, Margaret E; Donnelly, Michael; Ellis, Geraint; Hutchinson, George; Prior, Lindsay; Stevenson, Michael; Kee, Frank

2013-08-23

There is a dearth of evidence regarding the impact of urban regeneration projects on public health, particularly the nature and degree to which urban regeneration impacts upon health-related behaviour change. Natural experiment methodology enables comprehensive large-scale evaluations of such interventions. The Connswater Community Greenway in Belfast is a major urban regeneration project involving the development of a 9 km linear park, including the provision of new cycle paths and walkways. In addition to the environmental improvements, this complex intervention involves a number of programmes to promote physical activity in the regenerated area. The project affords a unique opportunity to investigate the public health impact of urban regeneration. The evaluation framework was informed by the socio-ecological model and guided by the RE-AIM Framework. Key components include: (1) a quasi-experimental before-and-after survey of the Greenway population (repeated cross-sectional design), in tandem with data from a parallel Northern Ireland-wide survey for comparison; (2) an assessment of changes in the local built environment and of walkability using geographic information systems; (3) semi-structured interviews with a purposive sample of survey respondents, and a range of community stakeholders, before and after the regeneration project; and (4) a cost-effectiveness analysis. The primary outcome is change in proportion of individuals identified as being regularly physically active, according to the current UK recommendations. The RE-AIM Framework will be used to make an overall assessment of the impact of the Greenway on the physical activity behaviour of local residents. The Connswater Community Greenway provides a significant opportunity to achieve long-term, population level behaviour change. We argue that urban regeneration may be conceptualised meaningfully as a complex intervention comprising multiple components with the potential, individually and interactively, to affect the behaviour of a diverse population. The development and implementation of our comprehensive evaluation framework reflects this complexity and illuminates an approach to the empirical, rigorous evaluation of urban regeneration. More specifically, this study will add to the much needed evidence-base about the impact of urban regeneration on public health as well as having important implications for the development of natural experiment methodology.

Understanding Rural-Urban Differences in Depressive Symptoms Among Older Adults in China

PubMed Central

Li, Lydia W.; Liu, Jinyu; Xu, Hongwei; Zhang, Zhenmei

2016-01-01

Objectives Studies have reported that rural elders in China have higher levels of depression than their urban peers. We aimed to examine the extent to which four sets of factors (socioeconomic status (SES), healthcare access, health status, social support and participation) account for such rural-urban differences. Methods Cross-sectional data from the 2011 China Health and Retirement Longitudinal Study were analyzed. A representative sample (N = 5,103) of older Chinese (age 60+) was included. Depressive symptoms were measured by the CESD-10. Multilevel linear regression was conducted. Results Rural elders had more depressive symptoms than urban elders. When SES at the individual-, household- and community-level was simultaneously controlled, the rural-urban difference lost its statistical significance. Health status, social support and social participation accounted for some, whereas healthcare access explained almost none, of the rural-urban difference. Discussion Results suggest that SES is the predominant factor accounting for the rural-urban depression gap in China. PMID:26100620

NIEHS/EPA Children’s Environmental Health Centers: Novel Methods to Assess Effects of Chemicals on Child Development

EPA Pesticide Factsheets

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

Urban greenness influences airborne bacterial community composition.

PubMed

Mhuireach, Gwynne; Johnson, Bart R; Altrichter, Adam E; Ladau, Joshua; Meadow, James F; Pollard, Katherine S; Green, Jessica L

2016-11-15

Urban green space provides health benefits for city dwellers, and new evidence suggests that microorganisms associated with soil and vegetation could play a role. While airborne microorganisms are ubiquitous in urban areas, the influence of nearby vegetation on airborne microbial communities remains poorly understood. We examined airborne microbial communities in parks and parking lots in Eugene, Oregon, using high-throughput sequencing of the bacterial 16S rRNA gene on the Illumina MiSeq platform to identify bacterial taxa, and GIS to measure vegetation cover in buffer zones of different diameters. Our goal was to explore variation among highly vegetated (parks) versus non-vegetated (parking lots) urban environments. A secondary objective was to evaluate passive versus active collection methods for outdoor airborne microbial sampling. Airborne bacterial communities from five parks were different from those of five parking lots (p=0.023), although alpha diversity was similar. Direct gradient analysis showed that the proportion of vegetated area within a 50m radius of the sampling station explained 15% of the variation in bacterial community composition. A number of key taxa, including several Acidobacteriaceae were substantially more abundant in parks, while parking lots had higher relative abundance of Acetobacteraceae. Parks had greater beta diversity than parking lots, i.e. individual parks were characterized by unique bacterial signatures, whereas parking lot communities tended to be similar to each other. Although parks and parking lots were selected to form pairs of nearby sites, spatial proximity did not appear to affect compositional similarity. Our results also showed that passive and active collection methods gave comparable results, indicating the "settling dish" method is effective for outdoor airborne sampling. This work sets a foundation for understanding how urban vegetation may impact microbial communities, with potential implications for designing neighborhoods and open space systems that foster better human health. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

URBAN SPRAWL MODELING, AIR QUALITY MONITORING AND RISK COMMUNICATION: THE NORTHEAST OHIO PROJECT

EPA Science Inventory

The Northeast Ohio Urban Sprawl, Air Quality Monitoring, and Communications Project (hereafter called the Northeast Ohio Project) provides local environmental and health information useful to residents, local officials, community planners, and others in a 15 county region in the ...

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria.

PubMed

Senbanjo, Idowu O; Olayiwola, Ibiyemi O; Afolabi, Wasiu A O

2016-01-01

Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother-child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively). Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities.

Dietary practices and nutritional status of under-five children in rural and urban communities of Lagos State, Nigeria

PubMed Central

Senbanjo, Idowu O.; Olayiwola, Ibiyemi O.; Afolabi, Wasiu A. O.

2016-01-01

Background: Evidence shows that urban children generally have a better nutritional status than their rural counterparts. However, data establishing whether this difference in prevalence of undernutrition could be ascribed to difference in dietary practices are few. Objective: The aim of this study was to compare dietary practices and nutritional status of children in rural and urban communities of Lagos State, Nigeria. Methods: This was a comparative-analytical study conducted using the multistage sampling technique to select the study cases. A total of 300 mother–child pairs were studied, including 150 each from rural and urban communities. Data collected include demographics, socioeconomic characteristics, feeding practices and anthropometric measurements of the participants. Food intake data were collected using 24-h dietary recall. Malnutrition in children was determined by calculating the prevalence of low height-for-age (stunting), low weight-for-age (underweight), and low weight-for-height (wasting) using the World Health Organization cutoff points. Results: The prevalence of exclusive breastfeeding for 6 months (25.3% vs. 28.7%; P = 0.516), use of formula feeds (48.7% vs. 44%; P = 0.077), and mean age of child at introduction of semisolid foods (7.54 ± 4.0 months vs. 8.51 ± 7.3 months; P = 0.117) were not significantly different between urban and rural communities. The diversity of food choices and frequencies of consumption were similar between urban and rural communities. However, prevalence levels of underweight and stunted children were significantly higher in rural than that of urban communities (19.4% vs. 9.3%, P < 0.001 and 43.3% vs. 12.6%, P < 0.001, respectively). Conclusions: Other risk factors besides inappropriate feeding practices need to be considered for higher prevalence of undernutrition among children in rural communities. PMID:27942096

Creative uncertainty

Treesearch

Victoria Marshall; Dil Hoda

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Investigating the Association of Health Literacy with Health Knowledge and Health Behavior Outcomes in a Sample of Urban Community College Undergraduates

ERIC Educational Resources Information Center

Hansen, Hardaye Ramsaroop; Shneyderman, Yuliya; Belcastro, Philip A.

2015-01-01

Background: There is a paucity of evidence associating health literacy metrics with adults' enhanced health knowledge, health status, health practices, or health behaviors. Purpose: Investigate whether health-literate undergraduates exhibit enhanced health knowledge, health status, health practices, or behaviors compared to non-health-literate…

Earthquakes in El Salvador: a descriptive study of health concerns in a rural community and the clinical implications--part II.

PubMed

Woersching, Joanna C; Snyder, Audrey E

2004-01-01

Results reported in Part I of the Earthquakes in El Salvador series (see Disaster Management & Response 2003;1:105-9) indicated clinically relevant findings. The findings indicated a need for greater public health action within all five categories reviewed: healthcare, access to healthcare, housing, food, water and sanitation. Significant results between urban and rural communities indicated a need for broader community aid, public health and sanitation services to rural areas. Faster and more efficient disaster management and care services throughout the San Sebastian community were also necessary modifications.

Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

PubMed

Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

2013-09-01

Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

The geography of crime and violence surrounding tobacco shops, medical marijuana dispensaries, and off-sale alcohol outlets in a large, urban low-income community of color.

PubMed

Subica, Andrew M; Douglas, Jason A; Kepple, Nancy J; Villanueva, Sandra; Grills, Cheryl T

2018-03-01

Tobacco shops, medical marijuana dispensaries (MMD), and off-sale alcohol outlets are legal and prevalent in South Los Angeles, California-a high-crime, low-income urban community of color. This research is the first to explore the geographic associations between these three legal drug outlets with surrounding crime and violence in a large low-income urban community of color. First, spatial buffer analyses were performed using point-location and publically accessible January-December 2014 crime data to examine the geography of all felony property and violent crimes occurring within 100, 200, 500, and 1000-foot buffers of these three legal drug outlet types across South Los Angeles. Next, spatial regression analyses explored the geographic associations between density of these outlets and property and violent crimes at the census tract level. Results indicated that mean property and violent crime rates within 100-foot buffers of tobacco shops and alcohol outlets-but not MMDs-substantially exceeded community-wide mean crime rates and rates around grocery/convenience stores (i.e., comparison properties licensed to sell both alcohol and tobacco). Spatial regression analyses confirmed that tobacco shops significantly positively associated with property and violent crimes after controlling for key neighborhood factors (poverty, renters, resident mobility, ethnic/racial heterogeneity). Thus, study findings provide the first empirical evidence that tobacco shops may constitute public health threats that associate with crime and violence in U.S. low-income urban communities of color. Implementing and enforcing control policies that regulate and monitor tobacco shops in these communities may promote community health by improving public safety. Copyright © 2017 Elsevier Inc. All rights reserved.

Measuring the food and built environments in urban centres: reliability and validity of the EURO-PREVOB Community Questionnaire.

PubMed

Pomerleau, J; Knai, C; Foster, C; Rutter, H; Darmon, N; Derflerova Brazdova, Z; Hadziomeragic, A F; Pekcan, G; Pudule, I; Robertson, A; Brunner, E; Suhrcke, M; Gabrijelcic Blenkus, M; Lhotska, L; Maiani, G; Mistura, L; Lobstein, T; Martin, B W; Elinder, L S; Logstrup, S; Racioppi, F; McKee, M

2013-03-01

The authors designed an instrument to measure objectively aspects of the built and food environments in urban areas, the EURO-PREVOB Community Questionnaire, within the EU-funded project 'Tackling the social and economic determinants of nutrition and physical activity for the prevention of obesity across Europe' (EURO-PREVOB). This paper describes its development, reliability, validity, feasibility and relevance to public health and obesity research. The Community Questionnaire is designed to measure key aspects of the food and built environments in urban areas of varying levels of affluence or deprivation, within different countries. The questionnaire assesses (1) the food environment and (2) the built environment. Pilot tests of the EURO-PREVOB Community Questionnaire were conducted in five to 10 purposively sampled urban areas of different socio-economic status in each of Ankara, Brno, Marseille, Riga, and Sarajevo. Inter-rater reliability was compared between two pairs of fieldworkers in each city centre using three methods: inter-observer agreement (IOA), kappa statistics, and intraclass correlation coefficients (ICCs). Data were collected successfully in all five cities. Overall reliability of the EURO-PREVOB Community Questionnaire was excellent (inter-observer agreement (IOA) > 0.87; intraclass correlation coefficients (ICC)s > 0.91 and kappa statistics > 0.7. However, assessment of certain aspects of the quality of the built environment yielded slightly lower IOA coefficients than the quantitative aspects. The EURO-PREVOB Community Questionnaire was found to be a reliable and practical observational tool for measuring differences in community-level data on environmental factors that can impact on dietary intake and physical activity. The next step is to evaluate its predictive power by collecting behavioural and anthropometric data relevant to obesity and its determinants. Copyright © 2013 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Retail Food Availability, Obesity, and Cigarette Smoking in Rural Communities

ERIC Educational Resources Information Center

Hosler, Akiko S.

2009-01-01

Context: Disparities in the availability of nutritionally important foods and their influence on health have been studied in US urban communities. Purpose: To assess the availability of selected retail foods and cigarettes, and explore ecologic relationships of the availability with obesity and smoking in rural communities. Methods: Inventories of…

Gender differences in the effects of community violence on mental health outcomes in a sample of low-income youth receiving psychiatric care.

PubMed

Javdani, Shabnam; Abdul-Adil, Jaleel; Suarez, Liza; Nichols, Sara R; Farmer, A David

2014-06-01

Previous research suggests that community violence impacts mental health outcomes, but much of this research has not (a) distinguished between different types of community violence, (b) examined gender differences, and (c) focused on youth living in urban poverty. The current study addresses these questions. Participants were 306 youth (23 % girls) and one parent/guardian receiving outpatient psychiatric services for disruptive behavior disorders in a large urban city. Youth and parents reported on youth's experience of different types of community violence (being a direct victim, hearing reports, and witnessing violence), and whether violence was directed toward a stranger or familiar. Outcomes included youth externalizing, internalizing, and posttraumatic stress symptoms assessed via parent and youth reports. Being a direct victim of violence accords risk for all mental health outcomes similarly for both boys and girls. However, gender differences emerged with respect to indirect violence, such that girls who hear reports of violence against people they know are at increased risk for all assessed mental health outcomes, and girls who witness violence against familiars are at increased risk for externalizing mental health symptoms in particular. There are gender differences in violence-related mental health etiology, with implications for intervention assessment and design.

Contracting with private providers for primary care services: evidence from urban China.

PubMed

Wang, Yan; Eggleston, Karen; Yu, Zhenjie; Zhang, Qiong

2013-01-17

Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China's recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance.We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services.

Contracting with private providers for primary care services: evidence from urban China

PubMed Central

2013-01-01

Controversy surrounds the role of the private sector in health service delivery, including primary care and population health services. China’s recent health reforms call for non-discrimination against private providers and emphasize strengthening primary care, but formal contracting-out initiatives remain few, and the associated empirical evidence is very limited. This paper presents a case study of contracting with private providers for urban primary and preventive health services in Shandong Province, China. The case study draws on three primary sources of data: administrative records; a household survey of over 1600 community residents in Weifang and City Y; and a provider survey of over 1000 staff at community health stations (CHS) in both Weifang and City Y. We supplement the quantitative data with one-on-one, in-depth interviews with key informants, including local officials in charge of public health and government finance. We find significant differences in patient mix: Residents in the communities served by private community health stations are of lower socioeconomic status (more likely to be uninsured and to report poor health), compared to residents in communities served by a government-owned CHS. Analysis of a household survey of 1013 residents shows that they are more willing to do a routine health exam at their neighborhood CHS if they are of low socioeconomic status (as measured either by education or income). Government and private community health stations in Weifang did not statistically differ in their performance on contracted dimensions, after controlling for size and other CHS characteristics. In contrast, the comparison City Y had lower performance and a large gap between public and private providers. We discuss why these patterns arose and what policymakers and residents considered to be the main issues and concerns regarding primary care services. PMID:23327666

Effects of a dietary self-management programme for community-dwelling older adults: a quasi-experimental design.

PubMed

Chen, Su-Hui; Huang, Yu-Ping; Shao, Jung-Hua

2017-09-01

Nutritional health plays a crucial role in determining successful ageing and differs by different living area. Although nutritional interventions have long been advocated, little research has directly assessed the effectiveness of nutritional interventions on community-dwelling older adults in urban and rural areas and compared intervention effects on these two populations. To examine the effectiveness of a 12-week dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours of community-dwelling older adults and to compare these effects in rural- and urban-dwelling older adults. For this quasi-experimental two-group study, older adults (≥65 years old) were recruited from two randomly selected public health centres in a rural north-eastern county and a northern city of Taiwan from January through December 2011. Outcomes included nutritional status, nutritional self-efficacy and health locus of control. Data were collected at baseline and 12 weeks later. To compare changes in outcome variables over time between the control (usual care) and intervention (nutritional programme) groups and between the urban- and rural-dwelling participants in the experimental group, we used generalised estimating equation analysis. Of the 129 participants, 120 completed this study (58 in the intervention group and 62 in the control group). After 12 weeks, the intervention group had significantly better nutritional status and higher internal health locus of control than the control group. Moreover, older rural participants who received the intervention tended towards higher nutritional self-efficacy and internal health locus of control than their urban counterparts. Our research findings support the positive effect of our nutritional self-management programme for community-dwelling older adults. The knowledge gained from this study can help stakeholders recognise the need for healthcare policy to establish effective strategies and sustainable intervention programmes for this population, especially those living in rural areas. © 2016 Nordic College of Caring Science.

Re-Designing Community Mental Health Services for Urban Children: Supporting Schooling to Promote Mental Health

PubMed Central

Atkins, Marc S.; Shernoff, Elisa S.; Frazier, Stacy L.; Schoenwald, Sonja K.; Cappella, Elise; Marinez-Lora, Ane; Mehta, Tara G.; Lakind, Davielle; Cua, Grace; Bhaumik, Runa; Bhaumik, Dulal

2015-01-01

Objective This study examined a school- and home-based mental health service model, Links to Learning (L2L), focused on empirical predictors of learning as primary goals for services in high poverty urban communities. Method Teacher key opinion leaders (KOLs) were identified through sociometric surveys and trained, with mental health providers (MHPs) and parent advocates (PAs), on evidence-based practices to enhance children’s learning. KOLs and MHPs co-facilitated professional development sessions for classroom teachers to disseminate two universal (Good Behavior Game, Peer Assisted Learning) and two targeted (Good News Notes, Daily Report Card) interventions. Group-based and home-based family education and support were delivered by MHPs and PAs for K-4th grade children diagnosed with one or more disruptive behavior disorder. Services were Medicaid-funded through four social service agencies (N = 17 providers) in seven schools (N = 136 teachers, 171 children) in a two (L2L vs. services-as-usual SAU]) by six (pre- and post-tests for three years) longitudinal design with random assignment of schools to conditions. SAU consisted of supported referral to a nearby social service agency. Results Mixed effects regression models indicated significant positive effects of L2L on mental health service use, classroom observations of academic engagement, teacher report of academic competence and social skills, and parent report of social skills. Nonsignificant between-group effects were found on teacher and parent report of problem behaviors, daily hassles, and curriculum based measures. Effects were strongest for young children, girls, and children with fewer symptoms. Conclusions Community mental health services targeting empirical predictors of learning can improve school and home behavior for children living in high poverty urban communities. PMID:26302252

Potential effectiveness of Community Health Strategy to promote exclusive breastfeeding in urban poor settings in Nairobi, Kenya: a quasi-experimental study.

PubMed

Kimani-Murage, E W; Norris, S A; Mutua, M K; Wekesah, F; Wanjohi, M; Muhia, N; Muriuki, P; Egondi, T; Kyobutungi, C; Ezeh, A C; Musoke, R N; McGarvey, S T; Madise, N J; Griffiths, P L

2016-04-01

Early nutrition is critical for later health and sustainable development. We determined potential effectiveness of the Kenyan Community Health Strategy in promoting exclusive breastfeeding (EBF) in urban poor settings in Nairobi, Kenya. We used a quasi-experimental study design, based on three studies [Pre-intervention (2007-2011; n=5824), Intervention (2012-2015; n=1110) and Comparison (2012-2014; n=487)], which followed mother-child pairs longitudinally to establish EBF rates from 0 to 6 months. The Maternal, Infant and Young Child Nutrition (MIYCN) study was a cluster randomized trial; the control arm (MIYCN-Control) received standard care involving community health workers (CHWs) visits for counselling on antenatal and postnatal care. The intervention arm (MIYCN-Intervention) received standard care and regular MIYCN counselling by trained CHWs. Both groups received MIYCN information materials. We tested differences in EBF rates from 0 to 6 months among four study groups (Pre-intervention, MIYCN-Intervention, MIYCN-Control and Comparison) using a χ(2) test and logistic regression. At 6 months, the prevalence of EBF was 2% in the Pre-intervention group compared with 55% in the MIYCN-Intervention group, 55% in the MIYCN-Control group and 3% in the Comparison group (P<0.05). After adjusting for baseline characteristics, the odds ratio for EBF from birth to 6 months was 66.9 (95% CI 45.4-96.4), 84.3 (95% CI 40.7-174.6) and 3.9 (95% CI 1.8-8.4) for the MIYCN-Intervention, MIYCN-Control and Comparison group, respectively, compared with the Pre-intervention group. There is potential effectiveness of the Kenya national Community Health Strategy in promoting EBF in urban poor settings where health care access is limited.

Will considerations of environmental sustainability revitalise the policy links between the urban environment and health?

PubMed

McMichael, Anthony J

2007-01-01

This paper explores when and how considerations of population health have influenced the creation, planning and management of cities. Cities--now the dominant human habitat--must be planned and managed sustainably in a world that is manifestly experiencing increasing environmental and social strains. Early industrialisation entailed crowding, squalor and industrial environmental blight; the two great associated public health hazards were infectious diseases and air pollution. These hazards have been largely controlled in rich countries. Today's main urban health hazards are obesity (with its life-shortening health consequences) and the huge contribution of cities to climate change with the resultant risks to population health. These and other health issues in urban environments need to be understood and addressed at the community or population level. This is an ecological challenge, crucial to attaining real sustainability.

Urban-rural differences in self-reported limiting long-term illness in Scotland.

PubMed

Levin, Kate A

2003-12-01

Previous research suggests that there are significant differences in health between urban and rural areas. The aim of this study is to describe the pattern and magnitude of urban-rural variation in health in Scotland and to examine the factors associated with health inequalities in urban and rural areas. The data used in this study were limiting long-term illness (LLTI) and socio-economic data collected by the 1991 Census. A rurality indicator was created using Scottish Household Survey rurality classifications. Multilevel Poisson regression modelling was carried out with LLTI as a health indicator for each type of rurality within Scotland. A variety of socio-economic factors were investigated for each rurality. Areas with the highest Standardized Illness Ratios (SIRs) (>125) are predominantly urban whereas the lowest SIRs (<75) are found in both urban and rural areas. Rural communities are more heterogeneous than urban areas in terms of their social make-up with relation to health; however, when these areas are split according to minor road length and different socio-economic factors are added, the model fit for each new model is improved and the reduction in total variation is comparable with that of the urban models. These findings suggest that rural areas should not be treated as a homogeneous group but should be subdivided into rural types.

Implementation of Urban Health Equity Assessment and Response Tool: a Case of Matsapha, Swaziland.

PubMed

Makadzange, Kevin; Radebe, Zamahlubi; Maseko, Nokuthula; Lukhele, Voyivoyi; Masuku, Sabelo; Fakudze, Gciniwe; Mengestu, Tigest Ketsela; Prasad, Amit

2018-04-03

Equity in health implies that ideally everyone could attain their full health potential and that no one should be disadvantaged from achieving this potential because of their social position or other socially determined circumstances. Making cities and human settlements inclusive, safe, resilient and sustainable contributes towards ensuring healthy lives and promoting well-being for all at all ages in dignity, equality and in a healthy environment. This paper illustrates a case of applying the Urban Health Equity Assessment and Response Tool (Urban HEART) in a small town in Africa. It describes the process followed, facilitating factors and challenges faced. A descriptive single-case study design using qualitative research methods was adopted to collect data from purposively selected respondents. The study revealed that residents of the Matsapha peri-urban informal settlements faced challenges with conditions of daily living which impacted negatively on their health. There were health equity gaps. The application of the tools was facilitated by the formation of an all-inclusive team, intersectoral collaboration and incorporating strategies for improving urban health equity into existing programmes and projects. Urban HEART is a simple and easy to use valuable tool for pursuing the goal of health equity towards attaining sustainable development through evidence-based approaches for intersectoral action and community involvement.

Patients' and community leaders' perceptions regarding conducting health behavior research in a diverse, urban clinic specializing in rheumatic diseases.

PubMed

Wallen, Gwenyth R; Middleton, Kimberly R; Miller-Davis, Claiborne; Tataw-Ayuketah, Gladys; Todaro, Alyssa; Rivera-Goba, Migdalia; Mittleman, Barbara B

2012-01-01

Disparities in the incidence, prevalence, severity, care, and outcomes for rheumatic diseases exist among racial and ethnic groups compared with White Americans. This paper describes a community-based participatory research (CBPR) approach engaging researchers, community leaders, and patients in purposeful dialogues related to the implementation of health behavior research in an urban rheumatic disease clinic. Seven focused discussions were led in either English or Spanish. Discussions were audiotaped and transcribed verbatim. Six community leaders and nine patients participated in the seven scheduled focused discussions. Transcripts uncovered five major themes that assisted with study design: trust, patient-provider relationship, study implementation suggestions, decreased functional capacity, and access to healthcare. Engaging community partners and patients in informal and formal discussions from early phases of research design through implementation, followed by systematic application of these insights, may serve to accelerate the potential for translation from findings into improved clinical practice and optimal outcomes.

Eco-bio-social research on dengue in Asia: a multicountry study on ecosystem and community-based approaches for the control of dengue vectors in urban and peri-urban Asia.

PubMed

Sommerfeld, Johannes; Kroeger, Axel

2012-12-01

This article provides an overview of methods and cross-site insights of a 5-year research and capacity building initiative conducted between 2006 and 2011 in six countries of South Asia (India, Sri Lanka) and South-East Asia (Indonesia, Myanmar, Philippines, Thailand).The initiative managed an interdisciplinary investigation of ecological, biological, and social (i.e., eco-bio-social) dimensions of dengue in urban and peri-urban areas, and developed community-based interventions aimed at reducing dengue vector breeding and viral transmission. The multicountry study comprised interdisciplinary research groups from six leading Asian research institutions. The groups conducted a detailed situation analysis to identify and characterize local eco-bio-social conditions, and formed a community-of-practice for EcoHealth research where group partners disseminated results and collaboratively developed site-specific intervention tools for vector-borne diseases. In sites where water containers produced more than 70% of Aedes pupae, interventions ranged from mechanical lid covers for containers to biological control. Where small discarded containers presented the main problem, groups experimented with solid waste management, composting and recycling schemes. Many intervention tools were locally produced and all tools were implemented through community partnership strategies. All sites developed socially and culturally appropriate health education materials. The study also mobilised and empowered women's, students' and community groups and at several sites organized new volunteer groups for environmental health. The initiative's programmes showed significant impact on vector densities in some sites. Other sites showed varying effect - partially attributable to the 'contamination' of control groups - yet led to significant outcomes at the community level where local groups united around broad interests in environmental hygiene and sanitation. The programme's findings are relevant for defining efficient, effective and ecologically sound vector control interventions based on local evidence and in accordance with WHO's strategy for integrated vector management.

Eco-bio-social research on dengue in Asia: a multicountry study on ecosystem and community-based approaches for the control of dengue vectors in urban and peri-urban Asia

PubMed Central

Sommerfeld, Johannes; Kroeger, Axel

2012-01-01

This article provides an overview of methods and cross-site insights of a 5-year research and capacity building initiative conducted between 2006 and 2011 in six countries of South Asia (India, Sri Lanka) and South-East Asia (Indonesia, Myanmar, Philippines, Thailand).The initiative managed an interdisciplinary investigation of ecological, biological, and social (i.e., eco-bio-social) dimensions of dengue in urban and peri-urban areas, and developed community-based interventions aimed at reducing dengue vector breeding and viral transmission. The multicountry study comprised interdisciplinary research groups from six leading Asian research institutions. The groups conducted a detailed situation analysis to identify and characterize local eco-bio-social conditions, and formed a community-of-practice for EcoHealth research where group partners disseminated results and collaboratively developed site-specific intervention tools for vector-borne diseases. In sites where water containers produced more than 70% of Aedes pupae, interventions ranged from mechanical lid covers for containers to biological control. Where small discarded containers presented the main problem, groups experimented with solid waste management, composting and recycling schemes. Many intervention tools were locally produced and all tools were implemented through community partnership strategies. All sites developed socially and culturally appropriate health education materials. The study also mobilised and empowered women’s, students’ and community groups and at several sites organized new volunteer groups for environmental health. The initiative’s programmes showed significant impact on vector densities in some sites. Other sites showed varying effect — partially attributable to the ‘contamination’ of control groups — yet led to significant outcomes at the community level where local groups united around broad interests in environmental hygiene and sanitation. The programme’s findings are relevant for defining efficient, effective and ecologically sound vector control interventions based on local evidence and in accordance with WHO’s strategy for integrated vector management. PMID:23318234

Developing a Learner-Centered Curriculum for a Rural Public Health Program

ERIC Educational Resources Information Center

Njoku, Anuli; Wakeel, Fathima; Reger, Michael; Jadhav, Emmanuel; Rowan, Julie

2017-01-01

Rural communities, compared with their urban counterparts, have higher rates of disease and adverse health conditions, fueling disparities in health outcomes. This encourages the need for effective curricula to engage students and enable them to address such disparate health outcomes as imminent health professionals. Incorporating learner-centered…

42 CFR 51c.102 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... urban or rural area designated by the Secretary as an area with a shortage of personal health services... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY HEALTH SERVICES General Provisions § 51c.102 Definitions. As used in this part: (a) Act means the Public Health...

42 CFR 51c.102 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... urban or rural area designated by the Secretary as an area with a shortage of personal health services... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS GRANTS FOR COMMUNITY HEALTH SERVICES General Provisions § 51c.102 Definitions. As used in this part: (a) Act means the Public Health...

Reported health, lifestyle and clinical manifestations associated with HIV status in people from rural and urban communities in the Free State Province, South Africa.

PubMed

Pienaar, Michélle; van Rooyen, Francois C; Walsh, Corinna M

2017-01-01

HIV infection impacts heavily on the infected individual's overall health status. To determine significant health, lifestyle (smoking and alcohol use) and independent clinical manifestations associated with HIV status in rural and urban communities. Adults aged between 25 and 64 years completed a questionnaire in a structured interview with each participant. Blood specimens were analysed in an accredited laboratory using standard techniques and controls. Anthropometric measurements were determined using standardised methods. Of the 567 rural participants, 97 (17.1%) were HIV-infected, and 172 (40.6%) of the 424 urban participants. More than half of HIV-infected rural participants used alcohol and more than 40% smoked. Median body mass index (BMI) of HIV-infected participants was lower than that of uninfected participants. Significantly more HIV-infected participants reported experiencing cough (rural), skin rash (urban), diarrhoea (rural and urban), vomiting (rural), loss of appetite (urban) and involuntary weight loss (rural). Significantly more HIV-uninfected participants reported diabetes mellitus (urban) and high blood pressure (rural and urban). In rural areas, HIV infection was positively associated with losing weight involuntarily (odds ratio 1.86), ever being diagnosed with tuberculosis (TB) (odds ratio 2.50) and being on TB treatment (odds ratio 3.29). In the urban sample, HIV infection was positively associated with having diarrhoea (odds ratio 2.04) and ever being diagnosed with TB (odds ratio 2.49). Involuntary weight loss and diarrhoea were most likely to predict the presence of HIV. In addition, present or past diagnosis of TB increased the odds of being HIV-infected. Information related to diarrhoea, weight loss and TB is easy to obtain from patients and should prompt healthcare workers to screen for HIV.

24 CFR 576.56 - Homeless assistance and participation.

Code of Federal Regulations, 2010 CFR

2010-04-01

... treatment, mental health treatment, counseling, supervision, and other services essential for achieving... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR COMMUNITY PLANNING AND DEVELOPMENT, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY FACILITIES EMERGENCY SHELTER GRANTS PROGRAM: STEWART B. McKINNEY...

Bonding, Bridging, and Linking Social Capital and Self-Rated Health among Chinese Adults: Use of the Anchoring Vignettes Technique.

PubMed

Chen, He; Meng, Tianguang

2015-01-01

Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between multivariate analyses results before and after the anchoring vignettes adjustment showed that the relationship between community-level social capital and self-rated health might be distorted if comparability problems are not addressed. In conclusion, the framework of bonding, bridging, and linking social capital helps us better understand the mechanism between social capital and self-rated health. Cultural and socioeconomic factors should be considered when designing health intervention policies using social capital. Moreover, we recommend that more studies improve the comparability of self-rated health by using the anchoring vignettes technique.

Bonding, Bridging, and Linking Social Capital and Self-Rated Health among Chinese Adults: Use of the Anchoring Vignettes Technique

PubMed Central

Chen, He; Meng, Tianguang

2015-01-01

Three main opposing camps exist over how social capital relates to population health, namely the social support perspective, the inequality thesis, and the political economy approach. The distinction among bonding, bridging, and linking social capital probably helps close the debates between these three camps, which is rarely investigated in existing literatures. Moreover, although self-rated health is a frequently used health indicator in studies on the relationship between social capital and health, the interpersonal incomparability of this measure has been largely neglected. This study has two main objectives. Firstly, we aim to investigate the relationship between bonding, bridging, and linking social capital and self-rated health among Chinese adults. Secondly, we aim to improve the interpersonal comparability in self-rated health measurement. We use data from a nationally representative survey in China. Self-rated health was adjusted using the anchoring vignettes technique to improve comparability. Two-level ordinal logistic regression was performed to model the association between social capital and self-rated health at both individual and community levels. The interaction between residence and social capital was included to examine urban/rural disparities in the relationship. We found that most social capital indicators had a significant relationship with adjusted self-rated health of Chinese adults, but the relationships were mixed. Individual-level bonding, linking social capital, and community-level bridging social capital were positively related with health. Significant urban/rural disparities appeared in the association between community-level bonding, linking social capital, and adjusted self-rated health. For example, people living in communities with higher bonding social capital tended to report poorer adjusted self-rated health in urban areas, but the opposite tendency held for rural areas. Furthermore, the comparison between multivariate analyses results before and after the anchoring vignettes adjustment showed that the relationship between community-level social capital and self-rated health might be distorted if comparability problems are not addressed. In conclusion, the framework of bonding, bridging, and linking social capital helps us better understand the mechanism between social capital and self-rated health. Cultural and socioeconomic factors should be considered when designing health intervention policies using social capital. Moreover, we recommend that more studies improve the comparability of self-rated health by using the anchoring vignettes technique. PMID:26569107

Evaluation of two strategies for heart health promotion by direct mail in a low-income urban community.

PubMed

O'Loughlin, J; Paradis, G; Meshefedjian, G

1997-01-01

The objective of this study was to evaluate the reach of mass mailings of heart health education print materials in a low-income, urban community. Materials included a monthly newsletter and a self-help behavior change kit, both distributed to all 12,789 households in the study community. Recall, use, and self-reported impact of the materials were measured in a cross-sectional survey of a random sample of 345 adults conducted 2 weeks after distribution of the kit and 18 months after delivery of the first newsletter. Over one-third of the subjects (38.6%) recalled the newsletter and 27.9% had read one or more newsletters; 21.7% recalled the kit and 10.8% had read it. Few subjects had read both materials. Female gender and older age were independent correlates of having seen and read the newsletters. Older age, being widowed/separated/divorced, and infrequent physical activity were correlates of having seen and read the kit. Although the newsletter and kit formats might appeal to different segments of the population, mass mailings of heart health education print materials in a low-income urban community can reach large numbers of individuals. The cost effectiveness of repeated mailings of short, simple newsletters might be higher than a single mailing of a more complex behavior change kit.

Integrated pest management in an urban community: a successful partnership for prevention.

PubMed

Brenner, Barbara L; Markowitz, Steven; Rivera, Maribel; Romero, Harry; Weeks, Matthew; Sanchez, Elizabeth; Deych, Elena; Garg, Anjali; Godbold, James; Wolff, Mary S; Landrigan, Philip J; Berkowitz, Gertrud

2003-10-01

Pesticides, applied in large quantities in urban communities to control cockroaches, pose potential threats to health, especially to children, who have proportionately greater exposures and unique, developmentally determined vulnerabilities. Integrated pest management (IPM) relies on nonchemical tools--cleaning of food residues, removal of potential nutrients, and sealing cracks and crevices. Least toxic pesticides are used sparingly. To evaluate IPM's effectiveness, the Mount Sinai Children's Environmental Health and Disease Prevention Research Center, in partnership with two community health centers in East Harlem, New York City (NY, USA), undertook a prospective intervention trial. Families (n = 131) enrolled when mothers came to the centers for prenatal care. Household cockroach infestation was measured by glue traps at baseline and 6 months afterward. The intervention group received individually tailored IPM education, repairs, least-toxic pest control application, and supplies, with biweekly pest monitoring for 2 months and monthly for 4 months. The control group, residing in East Harlem and demographically and socioeconomically similar to the intervention group, received an injury prevention intervention. The proportion of intervention households with cockroaches declined significantly after 6 months (from 80.5 to 39.0%). Control group levels were essentially unchanged (from 78.1 to 81.3%). The cost, including repairs, of individually tailored IPM was equal to or lower than traditional chemically based pest control. These findings demonstrate that individually tailored IPM can be successful and cost-effective in an urban community.

Integrated pest management in an urban community: a successful partnership for prevention.

PubMed Central

Brenner, Barbara L; Markowitz, Steven; Rivera, Maribel; Romero, Harry; Weeks, Matthew; Sanchez, Elizabeth; Deych, Elena; Garg, Anjali; Godbold, James; Wolff, Mary S; Landrigan, Philip J; Berkowitz, Gertrud

2003-01-01

Pesticides, applied in large quantities in urban communities to control cockroaches, pose potential threats to health, especially to children, who have proportionately greater exposures and unique, developmentally determined vulnerabilities. Integrated pest management (IPM) relies on nonchemical tools--cleaning of food residues, removal of potential nutrients, and sealing cracks and crevices. Least toxic pesticides are used sparingly. To evaluate IPM's effectiveness, the Mount Sinai Children's Environmental Health and Disease Prevention Research Center, in partnership with two community health centers in East Harlem, New York City (NY, USA), undertook a prospective intervention trial. Families (n = 131) enrolled when mothers came to the centers for prenatal care. Household cockroach infestation was measured by glue traps at baseline and 6 months afterward. The intervention group received individually tailored IPM education, repairs, least-toxic pest control application, and supplies, with biweekly pest monitoring for 2 months and monthly for 4 months. The control group, residing in East Harlem and demographically and socioeconomically similar to the intervention group, received an injury prevention intervention. The proportion of intervention households with cockroaches declined significantly after 6 months (from 80.5 to 39.0%). Control group levels were essentially unchanged (from 78.1 to 81.3%). The cost, including repairs, of individually tailored IPM was equal to or lower than traditional chemically based pest control. These findings demonstrate that individually tailored IPM can be successful and cost-effective in an urban community. PMID:14527845

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study

PubMed Central

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-01-01

Objectives Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Setting Urban poor community in the Southeast district of Delhi, India. Participants We randomly sampled 1849 children aged 1–3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria–pertussis–tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers’ recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Results Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Conclusions Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities. Trial registration number CTRI/2011/091/000095. PMID:27566644

Community-centered responses to Ebola in urban Liberia: the view from below.

PubMed

Abramowitz, Sharon Alane; McLean, Kristen E; McKune, Sarah Lindley; Bardosh, Kevin Louis; Fallah, Mosoka; Monger, Josephine; Tehoungue, Kodjo; Omidian, Patricia A

2015-04-01

The West African Ebola epidemic has demonstrated that the existing range of medical and epidemiological responses to emerging disease outbreaks is insufficient, especially in post-conflict contexts with exceedingly poor healthcare infrastructures. In this context, community-based responses have proven vital for containing Ebola virus disease (EVD) and shifting the epidemic curve. Despite a surge in interest in local innovations that effectively contained the epidemic, the mechanisms for community-based response remain unclear. This study provides baseline information on community-based epidemic control priorities and identifies innovative local strategies for containing EVD in Liberia. This study was conducted in September 2014 in 15 communities in Monrovia and Montserrado County, Liberia--one of the epicenters of the Ebola outbreak. Findings from 15 focus group discussions with 386 community leaders identified strategies being undertaken and recommendations for what a community-based response to Ebola should look like under then-existing conditions. Data were collected on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networks and hotlines, response teams, Ebola treatment units (ETUs) and hospitals, the management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education. Findings have been presented as community-based strategies and recommendations for (1) prevention, (2) treatment and response, and (3) community sequelae and recovery. Several models for community-based management of the current Ebola outbreak were proposed. Additional findings indicate positive attitudes towards early Ebola survivors, and the need for community-based psychosocial support. Local communities' strategies and recommendations give insight into how urban Liberian communities contained the EVD outbreak while navigating the systemic failures of the initial state and international response. Communities in urban Liberia adapted to the epidemic using multiple coping strategies. In the absence of health, infrastructural and material supports, local people engaged in self-reliance in order to contain the epidemic at the micro-social level. These innovations were regarded as necessary, but as less desirable than a well-supported health-systems based response; and were seen as involving considerable individual, social, and public health costs, including heightened vulnerability to infection.

Transformation of the Urban Health Care Safety Net: The Devolution of a Public Responsibility.

PubMed

Kulesher, Robert

2015-01-01

Reduced spending in both federal and state programs and the closure of public hospitals have serious consequences for the health of urban dwellers, especially the poor and uninsured. Through a combination of economic factors, many municipalities have formed public-private partnerships and launched community initiatives to preserve some of the elements of the health care safety net. What once was a responsibility of municipal governments, the provision of health care to poor and uninsured populations, is now posing challenges for private-sector providers. This article identifies several factors that have contributed to the incremental demise of the publicly funded urban health care safety net and how local entities and the federal government are responding to the care of the poor and uninsured.

First Steps in Initiating an Effective Maternal, Neonatal, and Child Health Program in Urban Slums: the BRAC Manoshi Project's Experience with Community Engagement, Social Mapping, and Census Taking in Bangladesh.

PubMed

Marcil, Lucy; Afsana, Kaosar; Perry, Henry B

2016-02-01

The processes for implementing effective programs at scale in low-income countries have not been well-documented in the peer-reviewed literature. This article describes the initial steps taken by one such program--the BRAC Manoshi Project, which now reaches a population of 6.9 million. The project has achieved notable increases in facility births and reductions in maternal and neonatal mortality. The focus of the paper is on the initial steps--community engagement, social mapping, and census taking. Community engagement began with (1) engaging local leaders, (2) creating Maternal, Neonatal, and Child Health Committees for populations of approximately 10,000 people, (3) responding to advice from the community, (4) social mapping of the community, and (5) census taking. Social mapping involved community members working with BRAC staff to map all important physical features that affect how the community carries out its daily functions--such as alleys, lanes and roads, schools, mosques, markets, pharmacies, health facilities, latrine sites, and ponds. As the social mapping progressed, it became possible to conduct household censuses with maps identifying every household and listing family members by household. Again, this was a process of collaboration between BRAC staff and community members. Thus, social mapping and census taking were also instrumental for advancing community engagement. These three processes-community engagement, social mapping, and census taking--can be valuable strategies for strengthening health programs in urban slum settings of low-income countries.

‘Maintaining balance and harmony’: Javanese perceptions of health and cardiovascular disease

PubMed Central

Dewi, Fatwa S.T.; Weinehall, Lars; Öhman, Ann

2010-01-01

Community intervention programmes to reduce cardiovascular disease (CVD) risk factors within urban communities in developing countries are rare. One possible explanation is the difficulty of designing an intervention that corresponds to the local context and culture. Objectives To understand people's perceptions of health and CVD, and how people prevent CVD in an urban setting in Yogyakarta, Indonesia. Methods A qualitative study was performed through focus group discussions and individual research interviews. Participants were selected purposively in terms of socio-economic status (SES), lay people, community leaders and government officers. Data were analysed by using content analysis. Results Seven categories were identified: (1) heart disease is dangerous, (2) the cause of heart disease, (3) men have no time for health, (4) women are caretakers for health, (5) different information-seeking patterns, (6) the role of community leaders and (7) patterns of lay people's action. Each category consists of sub-categories according to the SES of participants. The main theme that emerged was one of balance and harmony, indicating the necessity of assuring a balance between ‘good’ and ‘bad’ habits. Conclusions The basic concepts of balance and harmony, which differ between low and high SES groups, must be understood when tailoring community interventions to reduce CVD risk factors. PMID:20411051

Depression among the urban poor in Peninsular Malaysia: a community based cross-sectional study.

PubMed

Tan, Kok Leong; Yadav, Hematram

2013-01-01

This community based cross-sectional study examined the prevalence and factors associated with depression among urban poor in Peninsular Malaysia. The Patient Health Questionnaire (PHQ-9) was used to determine the presence or absence of depression. The prevalence of depression among the urban poor was 12.3%. Factors significantly associated with depression included respondents under 25 years old, male gender, living in the area for less than four years and those who do not exercise regularly. It is important to identify individuals with depression and its associated factors early because depression can severely affect the quality of life.

Causative Factors of Social Inequality and its Impact on Community Health: a Neighbourhood Level Study in Midnapore Municipal Area, West Bengal, India

NASA Astrophysics Data System (ADS)

Roy, U.

2016-10-01

Health is socio-demographic construct of population. In an urban area social, economic and political systems simultaneously operate within a geographically defined space in which the urban dwellers accommodate and act as key player. As such the physical and social factors virtually affect the community health as a consequence of disparity in accessing health. Health disparities in smaller towns of the developing world have drawn serious attention as they are poorly suffering from the problems of `urban penalty'. This paper deals with statistical clustering of neighbourhoods on the basis of quality of life, social deprivation and multiple suffering quantified as the variables derived from measurable parameters. Neighbourhoods inequality has been mapped as per the score received by each neighbourhood in respect to the above three variables. Principal Component Analysis (PCA) has also been employed for grouping the neighbourhoods in social terms. Then it has been tried to examine relationship between health attainment and social status of the neighbourhoods. The study shows that status of health does not merely depend on socio-demographic and political factors but availability of healthcare facilities, health related behaviour, health perception and awareness have played significant roles. The findings of the study may be helpful for setting planning strategies most important of which would be inclusion of local people in catering health services.

Creating restorative settings: inclusive design considerations

Treesearch

David Kamp

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

The re-greening of public housing

Treesearch

Rob Bennaton

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Community Mobilization in Mumbai Slums to Improve Perinatal Care and Outcomes: A Cluster Randomized Controlled Trial

PubMed Central

More, Neena Shah; Bapat, Ujwala; Das, Sushmita; Alcock, Glyn; Patil, Sarita; Porel, Maya; Vaidya, Leena; Fernandez, Armida; Joshi, Wasundhara; Osrin, David

2012-01-01

Introduction Improving maternal and newborn health in low-income settings requires both health service and community action. Previous community initiatives have been predominantly rural, but India is urbanizing. While working to improve health service quality, we tested an intervention in which urban slum-dweller women's groups worked to improve local perinatal health. Methods and Findings A cluster randomized controlled trial in 24 intervention and 24 control settlements covered a population of 283,000. In each intervention cluster, a facilitator supported women's groups through an action learning cycle in which they discussed perinatal experiences, improved their knowledge, and took local action. We monitored births, stillbirths, and neonatal deaths, and interviewed mothers at 6 weeks postpartum. The primary outcomes described perinatal care, maternal morbidity, and extended perinatal mortality. The analysis included 18,197 births over 3 years from 2006 to 2009. We found no differences between trial arms in uptake of antenatal care, reported work, rest, and diet in later pregnancy, institutional delivery, early and exclusive breastfeeding, or care-seeking. The stillbirth rate was non-significantly lower in the intervention arm (odds ratio 0.86, 95% CI 0.60–1.22), and the neonatal mortality rate higher (1.48, 1.06–2.08). The extended perinatal mortality rate did not differ between arms (1.19, 0.90–1.57). We have no evidence that these differences could be explained by the intervention. Conclusions Facilitating urban community groups was feasible, and there was evidence of behaviour change, but we did not see population-level effects on health care or mortality. In cities with multiple sources of health care, but inequitable access to services, community mobilization should be integrated with attempts to deliver services for the poorest and most vulnerable, and with initiatives to improve quality of care in both public and private sectors. Trial registration Current Controlled Trials ISRCTN96256793 Please see later in the article for the Editors' Summary PMID:22802737

Health literacy of an urban business community.

PubMed

Johnson, Barbara H; Hayes, Sandra C; Ekundayo, Olugbemiga T; Wheeler, Primus; Ford, D'Arcy M

2012-02-01

The impact of community-based organizations on the delivery of health care knowledge is well documented. Little research has focused on the importance of health literacy in the dissemination of health care information by minority small business owners. This study sampled 38 business owners within a local business district to assess their level of health literacy. Although adequate health literacy is not required to serve as a community resource, it may be necessary to understand the health literacy level of local business owners as gatekeepers in order to develop appropriate training/educational programs. The results of this descriptive cross-sectional study indicate that for sample of business owners, health literacy levels are adequate. The findings suggest the feasibility of using local business owners as disseminators of health-related materials to the communities in which they operate their businesses.

Community-Centered Responses to Ebola in Urban Liberia: The View from Below

PubMed Central

Abramowitz, Sharon Alane; McLean, Kristen E.; McKune, Sarah Lindley; Bardosh, Kevin Louis; Fallah, Mosoka; Monger, Josephine; Tehoungue, Kodjo; Omidian, Patricia A.

2015-01-01

Background The West African Ebola epidemic has demonstrated that the existing range of medical and epidemiological responses to emerging disease outbreaks is insufficient, especially in post-conflict contexts with exceedingly poor healthcare infrastructures. In this context, community-based responses have proven vital for containing Ebola virus disease (EVD) and shifting the epidemic curve. Despite a surge in interest in local innovations that effectively contained the epidemic, the mechanisms for community-based response remain unclear. This study provides baseline information on community-based epidemic control priorities and identifies innovative local strategies for containing EVD in Liberia. Methodology/Principal Findings This study was conducted in September 2014 in 15 communities in Monrovia and Montserrado County, Liberia – one of the epicenters of the Ebola outbreak. Findings from 15 focus group discussions with 386 community leaders identified strategies being undertaken and recommendations for what a community-based response to Ebola should look like under then-existing conditions. Data were collected on the following topics: prevention, surveillance, care-giving, community-based treatment and support, networks and hotlines, response teams, Ebola treatment units (ETUs) and hospitals, the management of corpses, quarantine and isolation, orphans, memorialization, and the need for community-based training and education. Findings have been presented as community-based strategies and recommendations for (1) prevention, (2) treatment and response, and (3) community sequelae and recovery. Several models for community-based management of the current Ebola outbreak were proposed. Additional findings indicate positive attitudes towards early Ebola survivors, and the need for community-based psychosocial support. Conclusions/Significance Local communities’ strategies and recommendations give insight into how urban Liberian communities contained the EVD outbreak while navigating the systemic failures of the initial state and international response. Communities in urban Liberia adapted to the epidemic using multiple coping strategies. In the absence of health, infrastructural and material supports, local people engaged in self-reliance in order to contain the epidemic at the micro-social level. These innovations were regarded as necessary, but as less desirable than a well-supported health-systems based response; and were seen as involving considerable individual, social, and public health costs, including heightened vulnerability to infection. PMID:25856072

Community partnership for healthy sleep: Research protocol.

PubMed

Redeker, Nancy S; Ordway, Monica R; Banasiak, Nancy; Caldwell, Barbara; Canapari, Craig; Crowley, Angela; Fenick, Ada; Jeon, Sangchoon; O'Connell, Meghan; Sude, Leslie; Sadler, Lois S

2018-02-01

Beginning early in life, sleep health, including adequate quality, quantity, and consistent sleep routines, is critical to growth and development, behavior, and mental and physical health. Children who live in economically stressed urban environments are at particular risk for sleep deficiency and its negative consequences. Although efficacious sleep health interventions are available, few address the context of economically stressed urban environments. The purpose of this paper is to describe a two-phase protocol for an ongoing NIH/NINR-funded community-engaged study designed to understand the perspectives of parents, community child care and pediatric health care providers about sleep habits, factors that contribute to sleep and sleep habits, sleep difficulty, and potentially useful sleep promotion strategies among children living in economically stressed urban environments. The social-ecological model guides this study. Phase I employs a convergent mixed-methods design, in which we are conducting semi-structured interviews with parents, childcare providers, and primary health care providers. We are collecting 9 days of objective sleep data (wrist actigraphy) from children who are 6-18 months (n = 15) and 19-36 months of age (n = 15) and parent reports of sleep and sleep-related factors using standard questionnaires. In Phase I, we will use a qualitative descriptive approach to analyze the interview data, and descriptive statistics to analyze the survey and actigraph data. In Phase II, we will use the information to develop a contextually relevant program to promote sleep health. Our long-term goal is to improve sleep health and sleep-related outcomes in these children. © 2017 Wiley Periodicals, Inc.

Asian Community Mental Health Services at 35: a pioneering ethnic organization (1973-2008).

PubMed

Vu, Catherine M; Schwartz, Sara L; Austin, Michael J

2011-01-01

Asian Community Mental Health Services is a nonprofit organization that delivers mental health services to primarily Asian and Pacific Islander communities. From its early beginnings and over its 35-year history, the agency has had to overcome numerous challenges, including gaining legitimacy as a culturally specific nonprofit, combating stigma surrounding mental health issues within the Asian Pacific Islander community, building resources to fund service delivery, and developing an educated and culturally sensitive workforce. The history of the organization highlights the multiple challenges and rewards of developing a culturally specific nonprofit in an urban area as well as the important role that internal operations play in relation to nonprofit expansion and growth.

Contributing to the Community: The Economic Significance of Academic Health Centers and Their Role in Neighborhood Development. Report IV. Report of the Task Force on Academic Health Centers.

ERIC Educational Resources Information Center

Commonwealth Fund, New York, NY.

This report is a selective analysis and assessment of quantitative data and field studies that reflect the economic role of the Academic Health Center (AHC) in the urban economy and in neighborhood revitalization. It describes the effect of a variety of cooperative efforts between local community organizations and AHCs, which usually include a…

Community Schools: a Public Health Opportunity to Reverse Urban Cycles of Disadvantage.

PubMed

Diamond, Catherine; Freudenberg, Nicholas

2016-12-01

Community schools link students, families, and communities to educate children and strengthen neighborhoods. They have become a popular model for education in many US cities in part because they build on community assets and address multiple determinants of educational disadvantage. Since community schools seek to have an impact on populations, not just the children enrolled, they provide an opportunity to improve community health. Community schools influence the health and education of neighborhood residents though three pathways: building trust, establishing norms, and linking people to networks and services. Through such services as school-based health centers, nutrition education, family mental health counseling, violence prevention, and sexuality education, these schools build on the multiple reciprocal relationships between health and education. By developing closer ties between community schools and neighborhood health programs, public health professionals can help to mobilize a powerful new resource for reducing the health and educational inequalities that now characterize US cities. We suggest an agenda for research, practice, and policy that can build the evidence needed to guide such a strategy.

Intersection of Living in a Rural Versus Urban Area and Race/Ethnicity in Explaining Access to Health Care in the United States

PubMed Central

Ford, Chandra L.; Wallace, Steven P.; Wang, May C.; Takahashi, Lois M.

2016-01-01

Objectives. To examine whether living in a rural versus urban area differentially exposes populations to social conditions associated with disparities in access to health care. Methods. We linked Medical Expenditure Panel Survey (2005–2010) data to geographic data from the American Community Survey (2005–2009) and Area Health Resource File (2010). We categorized census tracts as rural and urban by using the Rural–Urban Commuting Area Codes. Respondent sample sizes ranged from 49 839 to 105 306. Outcomes were access to a usual source of health care, cholesterol screening, cervical screening, dental visit within recommended intervals, and health care needs met. Results. African Americans in rural areas had lower odds of cholesterol screening (odds ratio[OR] = 0.37; 95% confidence interval[CI] = 0.25, 0.57) and cervical screening (OR = 0.48; 95% CI = 0.29, 0.80) than African Americans in urban areas. Whites had fewer screenings and dental visits in rural versus urban areas. There were mixed results for which racial/ethnic group had better access. Conclusions. Rural status confers additional disadvantage for most of the health care use measures, independently of poverty and health care supply. PMID:27310341

Health & Demographic Surveillance System Profile: The Nairobi Urban Health and Demographic Surveillance System (NUHDSS).

PubMed

Beguy, Donatien; Elung'ata, Patricia; Mberu, Blessing; Oduor, Clement; Wamukoya, Marylene; Nganyi, Bonface; Ezeh, Alex

2015-04-01

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was the first urban-based longitudinal health and demographic surveillance platform in sub-Saharan Africa (SSA). The NUHDSS was established in 2002 to provide a platform to investigate the long-term social, economic and health consequences of urban residence, and to serve as a primary research tool for intervention and impact evaluation studies focusing on the needs of the urban poor in SSA. Since its inception, the NUHDSS has successfully followed every year a population of about 65,000 individuals in 24,000 households in two slum communities--Korogocho and Viwandani--in Nairobi, Kenya. Data collected include key demographic and health information (births, deaths including verbal autopsy, in- and out-migration, immunization) and other information that characterizes living conditions in the slums (livelihood opportunities, household amenities and possessions, type of housing etc.). In addition to the routine data, it has provided a robust platform for nesting several studies examining the challenges of rapid urbanization in SSA and associated health and poverty dynamics. NUHDSS data are shared through internal and external collaborations, in accordance with the Centre's guidelines for publications, data sharing. © The Author 2015; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

Cholera Vaccination in Urban Haiti

PubMed Central

Rouzier, Vanessa; Severe, Karine; Juste, Marc Antoine Jean; Peck, Mireille; Perodin, Christian; Severe, Patrice; Deschamps, Marie Marcelle; Verdier, Rose Irene; Prince, Sabine; Francois, Jeannot; Cadet, Jean Ronald; Guillaume, Florence D.; Wright, Peter F.; Pape, Jean W.

2013-01-01

Successful and sustained efforts have been made to curtail the major cholera epidemic that occurred in Haiti in 2010 with the promotion of hygiene and sanitation measures, training of health personnel and establishment of treatment centers nationwide. Oral cholera vaccine (OCV) was introduced by the Haitian Ministry of Health as a pilot project in urban and rural areas. This paper reports the successful OCV pilot project led by GHESKIO Centers in the urban slums of Port-au-Prince where 52,357 persons received dose 1 and 90.8% received dose 2; estimated coverage of the at-risk community was 75%. This pilot study demonstrated the effort, community mobilization, and organizational capacity necessary to achieve these results in a challenging setting. The OCV intervention paved the way for the recent launching of a national cholera vaccination program integrated in a long-term ambitious and comprehensive plan to address Haiti's critical need in water security and sanitation. PMID:24106194

Functional Foods and Nutraceuticals in a Market of Bolivian Immigrants in Buenos Aires (Argentina)

PubMed Central

Pochettino, María Lelia; Puentes, Jeremías P.; Buet Costantino, Fernando; Arenas, Patricia M.; Ulibarri, Emilio A.; Hurrell, Julio A.

2012-01-01

This paper presents the results of a research in urban ethnobotany, conducted in a market of Bolivian immigrants in the neighborhood of Liniers, Ciudad Autónoma de Buenos Aires (Argentina). Functional foods and nutraceuticals belonging to 50 species of 18 families, its products, and uses were recorded. Some products are exclusive from the Bolivian community; others are frequent within the community, but they are also available in the general commercial circuit; they are introduced into it, generally, through shops called dietéticas (“health-food stores”), where products associated with the maintenance of health are sold. On this basis, the traditional and nontraditional components of the urban botanical knowledge were evaluated as well as its dynamics in relation to the diffusion of the products. Both the framework and methodological design are innovative for the studies of the urban botanical knowledge and the traditional markets in metropolitan areas. PMID:22203866

Social relationships and depression among people 65 years and over living in rural and urban areas of Quebec.

PubMed

Mechakra-Tahiri, Samia; Zunzunegui, Maria Victoria; Préville, Michel; Dubé, Micheline

2009-11-01

To compare the prevalence of depression within the elderly Quebec population residing in rural areas, urban areas and metropolitan Montreal, and to assess differences in the associations between social relationships and depression across these urban and rural settings. Data originate from the first wave of the ESA (Etude de Santé des Ainés) longitudinal study on mental health of community dwelling older persons aged over 65 (n = 2670). Depression, including major and minor depression, measured using a computer questionnaire; the ESA-Q developed by the research team and based on the DSM-IV criteria. Assessments of associations between depression and geographic area, informal social networks and community participation were estimated adjusting for demographic, socioeconomic and health characteristics. The prevalence of depression was higher in rural (17%) and urban areas (15.1%) than in metropolitan Montreal (10.3%). The odds ratio of rural (OR = 2.01 95% CI 1.59-2.68) and urban (OR = 1.75; 95% CI 1.25-2.45) areas compared to the metropolitan area increased slightly after adjustment by all social and health covariates. Our study indicated that social support and the lack of conflict in intimate relationships were associated with lower prevalence of depression in all areas. Geographic differences in depression exist within the elderly population in Quebec that may generate significant impact on their health and functional abilities. Further research should be conducted to explain these differences. Copyright 2009 John Wiley & Sons, Ltd.

Adapting Hypertension Self-Management Interventions to Enhance their Sustained Effectiveness among Urban African Americans

PubMed Central

Ameling, Jessica M.; Ephraim, Patti L.; Bone, Lee R.; Levine, David M.; Roter, Debra L.; Wolff, Jennifer L.; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L.; Noronha, Gary J.; Fagan, Peter J.; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A.; Aboumatar, Hanan J.; Albert, Michael C.; Flynn, Sarah J.; Boulware, L. Ebony

2014-01-01

African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions’ cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial. PMID:24569158

Meeting the linguistic needs of urban communities.

PubMed

Aponte, Judith

2009-05-01

In a collaborative effort to address the linguistic disparities within communities, an urban public university, school of nursing (SON), and a certified home healthcare (HHC) agency partnered in an Influenza Initiative. Undergraduate nursing students provided individual health screenings, education, and materials on the importance of influenza vaccination. In order to address the linguistic needs of the New York City (NYC) residents the nursing students, many of who were bilingual, served as translators for non-English speaking Spanish, Chinese, Russian, and Ukraine NYC residents.

Adapting hypertension self-management interventions to enhance their sustained effectiveness among urban African Americans.

PubMed

Ameling, Jessica M; Ephraim, Patti L; Bone, Lee R; Levine, David M; Roter, Debra L; Wolff, Jennifer L; Hill-Briggs, Felicia; Fitzpatrick, Stephanie L; Noronha, Gary J; Fagan, Peter J; Lewis-Boyer, LaPricia; Hickman, Debra; Simmons, Michelle; Purnell, Leon; Fisher, Annette; Cooper, Lisa A; Aboumatar, Hanan J; Albert, Michael C; Flynn, Sarah J; Boulware, L Ebony

2014-01-01

African Americans suffer disproportionately poor hypertension control despite the availability of efficacious interventions. Using principles of community-based participatory research and implementation science, we adapted established hypertension self-management interventions to enhance interventions' cultural relevance and potential for sustained effectiveness among urban African Americans. We obtained input from patients and their family members, their health care providers, and community members. The process required substantial time and resources, and the adapted interventions will be tested in a randomized controlled trial.

A Sexual Assault Primary Prevention Model with Diverse Urban Youth

ERIC Educational Resources Information Center

Smothers, Melissa Kraemer; Smothers, D. Brian

2011-01-01

In this study, a nonprofit community mental health clinic developed a socioecological model of sexual abuse prevention that was implemented in a public school. The goal of the program was to promote and create community change within individuals and the school community by reducing tolerance of sexual violence and sexual harassment. Participants…

A Community Prevention Approach to Peaceful Schools: Application of Wakanheza

ERIC Educational Resources Information Center

Erickson, Christina L.; Lee, Serita; Mattaini, Mark A.

2009-01-01

Schools have long recognized the importance of creating climates that are peaceful, laying the groundwork for good student academic learning. This article explores the work of a large urban school district as it applies a community violence prevention model developed by the local county public health department to create peaceful communities.…

Peculiarities of tuberculosis control in a scenario of urban violence in a disadvantaged community in Rio de Janeiro, Brazil.

PubMed

Souza, Fabiana Barbosa Assumpção de; Villa, Tereza Cristina Scatena; Cavalcante, Solange Cesar; Ruffino Netto, Antonio; Lopes, Luciane Blanco; Conde, Marcus Barreto

2007-01-01

To describe the difficulties and peculiarities encountered by health professionals during the treatment and investigation of contacts of tuberculosis (TB) patients in disadvantaged communities. A qualitative study carried out at health care facilities in Health Programming Area 1.0, located in the city of Rio de Janeiro, Brazil, which has a TB incidence rate of 240/100,000 inhabitants. From among the professionals responsible for visiting and treating TB cases and their contacts, two home visit agents and one clinical nurse were selected to be interviewed for the study. Data were transcribed and structured in the form of quotations, emphasizing the predominant ideas. The central ideas focus on the issue of violence, one significant facet of which is the set of rules imposed by narcotraffickers, and on the barriers to the movement of patients/health professionals for TB treatment, as well as on public safety (police). This study provides public health officials, as well as institutions that graduate health professionals, data for reflection and analysis of the difficulties that urban violence creates for the control of TB in a disadvantaged community.

Evolution of an academic-public library partnership.

PubMed

Engeszer, Robert J; Olmstadt, William; Daley, Jan; Norfolk, Monique; Krekeler, Kara; Rogers, Monica; Colditz, Graham; Anwuri, Victoria V; Morris, Scott; Voorhees, Mychal; McDonald, Brenda; Bernstein, Jackie; Schoening, Paul; Williams, Lee

2016-01-01

A partnership to improve access to health information via an urban public library system was established in St. Louis, Missouri, in 2011. A multiyear project was outlined that included an information needs assessment, a training class for public library staff, information kiosks at library branches for delivering printed consumer health materials, and a series of health-related programming. The partnership evolved to include social service and community organizations to carry out project goals and establish a sustainable program that met the health and wellness interests of the community.

Linking evidence to action on social determinants of health using Urban HEART in the Americas.

PubMed

Prasad, Amit; Groot, Ana Maria Mahecha; Monteiro, Teofilo; Murphy, Kelly; O'Campo, Patricia; Broide, Emilia Estivalet; Kano, Megumi

2013-12-01

To evaluate the experience of select cities in the Americas using the Urban Health Equity Assessment and Response Tool (Urban HEART) launched by the World Health Organization in 2010 and to determine its utility in supporting government efforts to improve health equity using the social determinants of health (SDH) approach. The Urban HEART experience was evaluated in four cities from 2010-2013: Guarulhos (Brazil), Toronto (Canada), and Bogotá and Medellín (Colombia). Reports were submitted by Urban HEART teams in each city and supplemented by first-hand accounts of key informants. The analysis considered each city's networks and the resources it used to implement Urban HEART; the process by which each city identified equity gaps and prioritized interventions; and finally, the facilitators and barriers encountered, along with next steps. In three cities, local governments spearheaded the process, while in the fourth (Toronto), academia initiated and led the process. All cities used Urban HEART as a platform to engage multiple stakeholders. Urban HEART's Matrix and Monitor were used to identify equity gaps within cities. While Bogotá and Medellín prioritized among existing interventions, Guarulhos adopted new interventions focused on deprived districts. Actions were taken on intermediate determinants, e.g., health systems access, and structural SDH, e.g., unemployment and human rights. Urban HEART provides local governments with a simple and systematic method for assessing and responding to health inequity. Through the SDH approach, the tool has provided a platform for intersectoral action and community involvement. While some areas of guidance could be strengthened, Urban HEART is a useful tool for directing local action on health inequities, and should be scaled up within the Region of the Americas, building upon current experience.

Change in stroke incidence from a population-based intervention trial in three urban communities in China.

PubMed

Wang, Wen-Zhi; Jiang, Bin; Wu, Sheng-Ping; Hong, Zhen; Yang, Qi-Dong; Sander, J W; Du, Xiao-Li; Bao, Qiu-Jiu

2007-01-01

Stroke has been the main cause of death in most urban residents in China since the 1990s. A community-based intervention trial carried out in China aimed to reduce the incidence and mortality of stroke. In 1991, two well-matched communities each with approximately 50,000 people were selected as intervention or control communities in the urban areas of Beijing, Shanghai and Changsha. Regular health education and health promotion activities were carried out between 1991 and 2000 in the intervention communities but no special action was taken in the control communities. Both fatal and nonfatal stroke cases were meticulously registered during the study in the two communities to assess the effect of long-term intervention. The trend in stroke incidence and the effect of intervention on stroke incidence were analyzed using a Poisson regression model adjusted for age, sex, year and city. Between 1991 and 2000, 2,273 first-ever stroke cases were registered in the intervention communities and 3,015 in the control communities. Geographic variation and changes in the incidence of stroke and its subtypes were found among these 3 cities. Through 10 years of intervention, incidence risks of all, ischemic and hemorrhagic strokes decreased by 11.4% (relative risk 0.8959; 95% confidence interval, CI, 0.8483-0.9460; p < 0.0001), 13.2% (relative risk 0.8676; 95% CI 0.8054-0.9345; p = 0.0002) and 7.2% (relative risk 0.9283; 95% CI 0.8517-1.0117; p = 0.0899), respectively, in the intervention compared with control communities. Accordingly, comprehensive community-based intervention measures could effectively reduce the incidence of stroke in the population. Copyright (c) 2007 S. Karger AG, Basel.

Mapping the Hidden Hazards: Community-Led Spatial Data Collection of Street-Level Environmental Stressors in a Degraded, Urban Watershed.

PubMed

Jelks, Na'Taki Osborne; Hawthorne, Timothy L; Dai, Dajun; Fuller, Christina H; Stauber, Christine

2018-04-22

We utilized a participatory mapping approach to collect point locations, photographs, and descriptive data about select built environment stressors identified and prioritized by community residents living in the Proctor Creek Watershed, a degraded, urban watershed in Northwest Atlanta, Georgia. Residents (watershed researchers) used an indicator identification framework to select three watershed stressors that influence urban livability: standing water, illegal dumping on land and in surface water, and faulty stormwater infrastructure. Through a community⁻university partnership and using Geographic Information Systems and digital mapping tools, watershed researchers and university students designed a mobile application (app) that enabled them to collect data associated with these stressors to create a spatial narrative, informed by local community knowledge, that offers visual documentation and representation of community conditions that negatively influence the environment, health, and quality of life in urban areas. By elevating the local knowledge and lived experience of community residents and codeveloping a relevant data collection tool, community residents generated fine-grained, street-level, actionable data. This process helped to fill gaps in publicly available datasets about environmental hazards in their watershed and helped residents initiate solution-oriented dialogue with government officials to address problem areas. We demonstrate that community-based knowledge can contribute to and extend scientific inquiry, as well as help communities to advance environmental justice and leverage opportunities for remediation and policy change.

Mapping the Hidden Hazards: Community-Led Spatial Data Collection of Street-Level Environmental Stressors in a Degraded, Urban Watershed

PubMed Central

Jelks, Na’Taki Osborne; Hawthorne, Timothy L.; Fuller, Christina H.; Stauber, Christine

2018-01-01

We utilized a participatory mapping approach to collect point locations, photographs, and descriptive data about select built environment stressors identified and prioritized by community residents living in the Proctor Creek Watershed, a degraded, urban watershed in Northwest Atlanta, Georgia. Residents (watershed researchers) used an indicator identification framework to select three watershed stressors that influence urban livability: standing water, illegal dumping on land and in surface water, and faulty stormwater infrastructure. Through a community–university partnership and using Geographic Information Systems and digital mapping tools, watershed researchers and university students designed a mobile application (app) that enabled them to collect data associated with these stressors to create a spatial narrative, informed by local community knowledge, that offers visual documentation and representation of community conditions that negatively influence the environment, health, and quality of life in urban areas. By elevating the local knowledge and lived experience of community residents and codeveloping a relevant data collection tool, community residents generated fine-grained, street-level, actionable data. This process helped to fill gaps in publicly available datasets about environmental hazards in their watershed and helped residents initiate solution-oriented dialogue with government officials to address problem areas. We demonstrate that community-based knowledge can contribute to and extend scientific inquiry, as well as help communities to advance environmental justice and leverage opportunities for remediation and policy change. PMID:29690570

Street vending and waste picking in developing countries: a long-standing hazardous occupational activity of the urban poor

PubMed Central

2016-01-01

Uncontrolled urbanization in developing countries has led to widespread urban poverty and increased susceptibility to environmental exposures owing to the hazardous occupational activities of the urban poor. Street vending and waste picking are the dominant works undertaken by the urban poor, and besides the physical hazards, it also exposes them to several pathogens and high levels of air pollutants present in the outdoor environment. The situation has severe consequences for the health of the workers. Eliminating these occupational activities from the urban landscape of developing countries should therefore receive urgent attention from the global health community and governments. In this article, we provide evidence to support this policy recommendation by documenting exposure experiences of the workers, the associated adverse health effects, whilst also outlining measures for addressing the problem sustainably. We conclude that with the adoption of the sustainable development goals (SDG), governments now have a commitment to address poverty and the associated occupational health hazards experienced by the poor through their choices to help achieve the health-related SDG target (3.9) of substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030. PMID:27467691

Street vending and waste picking in developing countries: a long-standing hazardous occupational activity of the urban poor.

PubMed

Amegah, Adeladza Kofi; Jaakkola, Jouni J K

2016-07-01

Uncontrolled urbanization in developing countries has led to widespread urban poverty and increased susceptibility to environmental exposures owing to the hazardous occupational activities of the urban poor. Street vending and waste picking are the dominant works undertaken by the urban poor, and besides the physical hazards, it also exposes them to several pathogens and high levels of air pollutants present in the outdoor environment. The situation has severe consequences for the health of the workers. Eliminating these occupational activities from the urban landscape of developing countries should therefore receive urgent attention from the global health community and governments. In this article, we provide evidence to support this policy recommendation by documenting exposure experiences of the workers, the associated adverse health effects, whilst also outlining measures for addressing the problem sustainably. We conclude that with the adoption of the sustainable development goals (SDG), governments now have a commitment to address poverty and the associated occupational health hazards experienced by the poor through their choices to help achieve the health-related SDG target (3.9) of substantially reducing the number of deaths and illnesses from hazardous chemicals and air, water, and soil pollution and contamination by 2030.

Prevalence of Mental Health Problems and Associated Risk Factors among Rural-to-Urban Migrant Children in Guangzhou, China

PubMed Central

Liu, Ke; Zheng, Jing; Liu, Jiali; You, Liming

2017-01-01

Rural-to-urban migration, which has achieved a huge scale during China’s economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen’s behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical. PMID:29135949

Prevalence of Mental Health Problems and Associated Risk Factors among Rural-to-Urban Migrant Children in Guangzhou, China.

PubMed

Wang, Jun; Liu, Ke; Zheng, Jing; Liu, Jiali; You, Liming

2017-11-14

Rural-to-urban migration, which has achieved a huge scale during China's economic reform, is a potential risk factor for the mental health of migrant children. To test this hypothesis, this study assessed the mental health status of rural-to-urban migrant children. Guided by Andersen's behavioral model, the study explored the risk factors associated with mental health. The study recruited 1182 fifth/sixth-grade children from four private and four public primary schools in Guangzhou in 2014 in a descriptive cross-sectional design. Mental health status was measured by the strengths and difficulties questionnaire. Predisposing characteristics including demographics (e.g., age, gender), social structure (e.g., education, occupation) and health beliefs (health attitude) were recorded. Enabling characteristics including family and community resources and the need for health services were analyzed to explore the risk factors. The results indicate that more rural-to-urban migrant children were classified in the abnormal (21.0%) or borderline (18.8%) categories based on the total difficulties scores, the proportions of which were much higher than those of local children (9.8% abnormal, 13.8% borderline). Factors associated with a greater likelihood of mental health problems included single-parent families, seeking health information actively, family income cannot meet basic needs and poor perceived health status. Compared with the local children, the rural-to-urban migrant children had relatively poor mental health, hence monitoring and supporting mental health for rural-urban migrant children is critical.

Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

PubMed Central

2011-01-01

Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a) Structural domains (health service performance; sustainability; and quality of care); (b) Process domains (health service utilisation and satisfaction); and (c) Outcome domains (health behaviours, health outcomes and community viability). Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how; what benefits have been realised and for whom; the level of community satisfaction with the service; and the impact of a health service on community viability. While the need to reduce the rural-urban health service disparity in Australia is pressing, the evidence regarding how to move forward is inadequate. This comprehensive evaluation will add significant new knowledge regarding the characteristics associated with a sustainable rural primary health care service. PMID:21356123

Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need

PubMed Central

2014-01-01

With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

Holistic Admissions in the Health Professions: Strategies for Leaders

ERIC Educational Resources Information Center

Artinian, Nancy T.; Drees, Betty M.; Glazer, Greer; Harris, Kevin; Kaufman, Lon S.; Lopez, Naty; Danek, Jennifer C.; Michaels, Julia

2017-01-01

In the wake of national health care reform, development of the future health care workforce has become more important than ever. Millions of newly insured patients, many from underserved urban communities, are seeking health care services. In order to provide high-quality care to rapidly diversifying patient populations, health care professionals…

Air Pollution, Economic Development of Communities, and Health Status Among the Elderly in Urban China

PubMed Central

Gu, Danan

2008-01-01

In Western societies, the impact of air pollution on residents' health is higher in less wealthy communities. However, it is not clear whether such an interaction effect applies to developing countries. The authors examine how the level of community development modifies the impact of air pollution on health outcomes of the Chinese elderly using data from the third wave of the Chinese Longitudinal Health Longevity Survey in 2002, which includes 7,358 elderly residents aged 65 or more years from 735 districts in 171 cities. The results show that, compared with a 1-point increase in the air pollution index in urban areas with a low gross domestic product, a similar increase in the air pollution index in areas with a high gross domestic product is associated with more difficulties in activities of daily living (odds ratio = 1.41, 95% confidence interval (CI): 1.09, 1.83), instrumental activities of daily living (linear coefficient = 0.98, 95% CI: 0.58, 1.37), and cognitive function (linear coefficient = 2.67, 95% CI: 1.97, 3.36), as well as a higher level of self-rated poor health (odds ratio = 2.20, 95% CI: 1.68, 2.86). Contrary to what has been found in the West, Chinese elderly who live in more developed urban areas are more susceptible to the effect of air pollution than are their counterparts living in less developed areas. PMID:18936437

NIEHS/EPA CEHCs: Formative Center for the Evaluation of Environmental Impacts on Fetal Development - Brown University

EPA Pesticide Factsheets

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

Performance of female volunteer community health workers in Dhaka urban slums.

PubMed

Alam, Khurshid; Tasneem, Sakiba; Oliveras, Elizabeth

2012-08-01

Volunteer community health workers (CHWs) are one approach to addressing the health workforce crisis in developing countries. BRAC, a large Bangladeshi NGO, a pioneer in this area, uses female volunteer CHWs as core workers in its health programs. After 25 years of implementing the CHW model in rural areas, BRAC has begun using female CHWs in urban slums through its community-based mother, newborn and child health interventions. However, the program experienced suboptimal performance among CHWs, with a high percentage of them remaining in their positions but becoming "inactive", not truly participating in daily community health activities. This suggests a need to better understand the relative importance of factors affecting their active participation and to recommend strategies for improving their participation. This mixed-method study included a descriptive correlational design to assess factors relating to level of activity of CHWs and focus group discussions to explore solutions to these problems. A sample of 542 current female CHWs from project areas participated in the survey. Financial incentives were the main factor linked to the activity of CHWs. CHWs who thought that running their families would be difficult without CHW income had more than three times greater odds to become active. In addition, social prestige and positive community feedback to the CHWs were important non-financial factors associated with level of activity. In order to improve volunteer CHWs' performance, a combination of financial and non-financial incentives should be used. Copyright © 2012 Elsevier Ltd. All rights reserved.

HIV/STD Stigmatization Fears as Health Seeking Barriers in China

PubMed Central

Lieber, Eli; Li, Li; Wu, Zunyou; Rotheram-Borus, Mary Jane; Guan, Jihui

2005-01-01

Internationally, stigma prohibits effective HIV/STD identification, prevention, and care. Interviews with 106 persons in an urban center in Eastern China, some know to have engaged in stigmatized risk acts (sex workers, STD clinic patients) and some vulnerable for stigmatization fears to influence health seeking behaviors (market employees, rural-to-urban migrants). Interviews focused on community norms, values, beliefs, and emotional and behavioral reactions to HIV/STD stigmatization related events. Attributions for infection were found to: mark individual's failure to adhere to sexuality norms; define a condition warranting the avoidance of infected persons and dismissal by medical professionals; and promote anticipation of negative emotions (i.e., shame, fear, and embarrassment) and devalued social roles and status. Strategies reported to avoid stigmatization include: avoiding HIV/STD knowledge; avoiding health care professionals, particularly in public settings; and conforming to community norms of shunning those suspected of risky behaviors. Results have direct implications for community marketing campaigns in China. PMID:16374668

Greater Baltimore Open Air: an Internet of Things (IoT) approach to citizen science and community-driven climate, air quality, and urban heat island monitoring

NASA Astrophysics Data System (ADS)

Scott, A.; Kelley, C.; Azdoud, Y.; Ambikapathi, R.; Hobson, M.; Lehman, A.; Ghugare, P.; He, C.; Zaitchik, B. F.; Waugh, D.; McCormack, M.; Baja, K.

2017-12-01

Anthropogenic activities alter the urban surface and surface atmosphere, generating heat and pollutants that have known detrimental impacts on health. Monitoring these environmental variables in urban environments is made difficult by the spatial heterogeneity of urban environments, meaning that two nearby locations may have significantly different temperatures, humidities, or gas concentrations. Thus, urban monitoring often requires more densely placed monitors than current standards or budgets allow. Recent advances in low-cost sensors and Internet of Things (IoT) enabled hardware offer possible solutions. We present an autonomous wireless, open-source, IoT-enabled environmental monitor called a WeatherCube, developed for the Greater Baltimore Open Air project, funded in part by the EPA SmartCity Challenge. The WeatherCube is suitable for urban monitoring and capable of measuring meteorological variables (temperature and humidity) as well as air quality (ozone, nitrogen dioxide, and sulfur dioxide). The WeatherCube devices were built in collaboration with Johns Hopkins University, local government, and community members, including through an innovative job training program. Monitors are hosted by community partners and libraries throughout Baltimore city and surrounding communities. We present the first wave of data collected by the Greater Baltimore Open Air project and compare it to data collected by the Maryland Department of the Environment (MDE). Additionally, we will provide an overview of our experience engaging with the local makers, citizen scientists, and environmental groups to improve their urban environmental monitoring. By developing low-cost devices tailored for urban environmental monitoring, we present an innovative model for both conducting research and community outreach.

Influence of urban neighbourhood environment on physical activity and obesity-related diseases.

PubMed

Lee, H; Kang, H-M; Ko, Y-J; Kim, H-S; Kim, Y-J; Bae, W K; Park, S; Cho, B

2015-09-01

The impact of characteristics of neighbourhood environment on physical activity and obesity-related diseases is still the subject of debate. This study aimed to explore the impact of urban neighbourhood environment on physical activity and obesity-related diseases. Cross-sectional study. Individuals who participated in the 2009 national health-screening programme, submitted all necessary information, and had lived in Community 1 (Haengdang) or Community 2 (Ilsan) for at least 2 years (n = 16,178) were selected for inclusion in this study. Anthropometric measures were taken and physical activity was assessed using a short questionnaire. No significant difference in the trigger factors for walking, including the amount of neighbourhood park space, number of shopping malls, and distance between the community and shopping malls, was found between the two communities. However, Community 2 had a better street environment than Community 1. Participants who lived in Community 2 were more physically active [adjusted odds ratio (OR) 1.31, 95% confidence interval (CI) 1.16-1.48] and walked more regularly (adjusted OR 1.09, 95% CI 1.02-1.17) than participants who lived in Community 1, and were less likely to have abdominal obesity (adjusted OR 0.83, 95% CI 0.77-0.91), hypertension (adjusted OR 0.88, 95% CI 0.80-0.97) and diabetes (adjusted OR 0.86, 95% CI 0.75-0.99). However, the risk of dyslipidaemia, especially in terms of low-density lipoprotein cholesterol, was higher in Community 2. These results suggest that a walkable environment has a positive influence on hypertension and diabetes, and physical activity is the possible mechanism for this association. A walkable environment may function as an important tool for health promotion in urban areas. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The theatre: an effective tool for health promotion.

PubMed

Seguin, A; Rancourt, C

1996-01-01

In Africa and in North America, in both rural and urban settings, theatre can be an effective means of health promotion. Projects on women's health, care for patients with mental disorders, and AIDS prevention show the usefulness of this medium for community action programmes.

Value of urban green spaces in promoting healthy living and wellbeing: prospects for planning.

PubMed

Lee, Andrew Chee Keng; Jordan, Hannah C; Horsley, Jason

2015-01-01

There has been considerable work done in recent years exploring the value of urban green space for health and wellbeing. Urban green spaces provide environmental benefits through their effects on negating urban heat, offsetting greenhouse gas emissions, and attenuating storm water. They also have direct health benefits by providing urban residents spaces for physical activity and social interaction, and allowing psychological restoration to take place. Consequently, there is a real need to understand the mechanisms by which these benefits accrue. Previously, much of the focus has been on the characteristics of the urban green space that are likely to influence its use, such as its accessibility, quality, facilities, attractiveness, and security. This assumes a causal relationship, when in reality the relationship is more complex and multifactorial. It is more likely that it is the functionality of the green space, be it for exercise or sociocultural activities, rather than its character, which translates to the reported benefits. Challenges exist, such as competing urban planning priorities, economic considerations, and market forces. There is thus a need for urban planning to match the health benefits sought with the needs of the community and the functionality that the urban green space will serve.

Factors associated with traditional Chinese medicine utilization among urban community health centers in Hubei Province of China.

PubMed

Cai, Yi; Mao, Zongfu; Xu, Bruce; Wu, Bei

2015-03-01

This study aims to examine resources and utilization of traditional Chinese medicine (TCM) and factors influencing TCM utilization in urban community health centers (CHCs) in Hubei Province of China. A cross-sectional survey including 234 government-owned CHCs was conducted in 2009. One-way analysis of variance analysis and a Poisson regression model were used to examine distribution of TCM resources and factors influencing TCM utilization. This study found unequal distribution of TCM resources among districts. TCM outpatient visits were positively associated with higher economic development districts, lower initial capital investment of the CHCs, health services covered by health insurance, higher qualification of TCM physicians, provision of TCM health records and rehabilitation, and greater availability of herbal medicine. To achieve equal access to TCM services, policy makers should consider the socioeconomic differences and income groups, provide training for TCM physicians, build pathway to recruit senior TCM physicians, and cover more TCM therapies by health insurance. © 2013 APJPH.

Uncovering the historic environmental hazards of urban brownfields.

PubMed

Litt, Jill S; Burke, Thomas A

2002-12-01

In Baltimore, over 1,000 vacant industrial sites persist across its urban landscape, yet little is known about the potential environmental health risks that may undermine future cleanup and redevelopment activities and the health of those in communities near these sites. This study examined the characteristics of urban brownfield properties in southeast Baltimore, Maryland, and screened sites for their potential environmental hazards. In addition, demographic and health data were evaluated to profile the social and health status of those in brownfield communities. The results show that brownfields in southeast Baltimore represent a range of historic operations, including metal smelting, oil refining, warehousing, and transportation, as well as paints, plastics, and metals manufacturing. The screening method identified a range of substances associated with these properties, including heavy metals, chlorinated hydrocarbons, and polycyclic aromatic hydrocarbons, all of which are suspected or recognized toxicants, and many of which are persistent in the environment. Spatially, these sites are concentrated in white, working class neighborhoods in which poverty levels exceed and educational attainment lags behind state and national averages. Moreover, these sites are concentrated in communities in which excess mortality rates due to respiratory disease, cancer, and heart disease exist when compared to the city, state, and national averages. This investigation demonstrated the usefulness of historic archives, real estate records, regulatory files, and national hazard-tracking systems based on standard industrial classification (SIC) to screen brownfield properties for their hazard potential. This analysis provides the foundation for further site monitoring and testing, cleanup and redevelopment priority setting, risk management strategies, and neighborhood planning, and it illustrates the need for increased health surveillance and disease prevention strategies in affected communities.

Do slums matter? Location and early childhood preventive care choices among urban residents of Bangladesh.

PubMed

Heller, Lauren R

2013-10-01

Upward trends in the relative proportions of slum residents in developing countries have led to widespread concern regarding the impact of slum residency on health behaviors. Measurement of these impacts requires recognizing that unobservable household characteristics that affect the location decision may also affect health care choices and outcomes. To address the potential for bias, this paper models the location decision and the household's demand for maternal and child health services simultaneously using a flexible, semi-parametric approach. It uses a unique urban data set from Bangladesh that incorporates sophisticated geographical mapping techniques to carefully delineate between slum and non-slum areas at a particular point in time. The results suggest that accounting for the endogenous location decision of a family substantially reduces bias in estimated marginal effects of slum residence on preventive care demand. While community infrastructure variables appear correlated with preventive care demand, the causal effect of the availability of primary health care facilities is indistinguishable from zero when unobserved heterogeneity is taken into account. The findings suggest that improvements in community infrastructure in urban areas of developing countries are a more favorable health policy solution at the margin than the construction of additional health care facilities. Copyright © 2013 Elsevier Ltd. All rights reserved.

Improving community health through marketing exchanges: A participatory action research study on water, sanitation, and hygiene in three Melanesian countries.

PubMed

Barrington, D J; Sridharan, S; Saunders, S G; Souter, R T; Bartram, J; Shields, K F; Meo, S; Kearton, A; Hughes, R K

2016-12-01

Diseases related to poor water, sanitation and hygiene (WaSH) are major causes of mortality and morbidity. While pursuing marketing approaches to WaSH to improve health outcomes is often narrowly associated with monetary exchange, marketing theory recognises four broad marketing exchange archetypes: market-based, non-market-based, command-based and culturally determined. This diversity reflects the need for parameters broader than monetary exchange when improving WaSH. This study applied a participatory action research process to investigate how impoverished communities in Melanesian urban and peri-urban informal settlements attempt to meet their WaSH needs through marketing exchange. Exchanges of all four archetypes were present, often in combination. Motivations for participating in the marketing exchanges were based on social relationships alongside WaSH needs, health aspirations and financial circumstances. By leveraging these motivations and pre-existing, self-determined marketing exchanges, WaSH practitioners may be able to foster WaSH marketing exchanges consistent with local context and capabilities, in turn improving community physical, mental and social health. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Experience of Implementing Urban HEART Barcelona: a Tool for Action.

PubMed

Novoa, Ana M; Pérez, Glòria; Espelt, Albert; Echave, Cynthia; de Olalla, Patricia G; Calvo, M Jesús; Pasarín, Maribel; Diez, Èlia; Borrell, Carme; Calvo, M Jesús; Cormenzana, Berta; Cortés, Imma; Diez, Èlia; Echave, Cynthia; Espelt, Albert; de Olalla, Patrícia G; Gòmez, Josep; Novoa, Ana M; Pallarès, Montserrat; Pérez, Glòria; Rodríguez-Sanz, Maica

2017-10-16

Urban Health Equity Assessment and Response Tool (HEART) is a tool developed by the World Health Organization whose objective is to provide evidence on urban health inequalities so as to help to decide the best interventions aimed to promote urban health equity. The aim of this paper is to describe the experience of implementing Urban HEART in Barcelona city, both the adaptation of Urban HEART to the city of Barcelona, its use as a means of identifying and monitoring health inequalities among city neighbourhoods, and the difficulties and barriers encountered throughout the process. Although ASPB public health technicians participated in the Urban HEART Advisory Group, had large experience in health inequalities analysis and research and showed interest in implementing the tool, it was not until 2015, when the city council was governed by a new left-wing party for which reducing health inequalities was a priority that Urban HEART could be used. A provisional matrix was developed, including both health and health determinant indicators, which allowed to show how some neighbourhoods in the city systematically fare worse for most of the indicators while others systematically fare better. It also allowed to identify 18 neighbourhoods-those which fared worse in most indicators-which were considered a priority for intervention, which entered the Health in the Barcelona Neighbourhoods programme and the Neighbourhoods Plan. This provisional version was reviewed and improved by the Urban HEART Barcelona Working Group. Technicians with experience in public health and/or in indicator and database management were asked to indicate suitability and relevance from a list of potential indicators. The definitive Urban HEART Barcelona version included 15 indicators from the five Urban HEART domains and improved the previous version in several requirements. Several barriers were encountered, such as having to estimate indicators in scarcely populated areas or finding adequate indicators for the physical context domain. In conclusion, the Urban HEART tool allowed to identify urban inequalities in the city of Barcelona and to include health inequalities in the public debate. It also allowed to reinforce the community health programme Health in the Barcelona Neighbourhoods as well as other city programmes aimed at reducing health inequalities. A strong political will is essential to place health inequalities in the political agenda and implement policies to tackle them.

[Community diagnosis using qualitative techniques of expectations and experiences in a health area in need of social transformation].

PubMed

Ramos Ruiz, Juan Andrés; Pérez Milena, Alejandro; Enguix Martínez, Natalia; Alvarez Nieto, Carmen; Martínez Fernández, M Luz

2013-01-01

To know the views, experiences and expectations of care provided by the Andalusian Public Health System (SSPA) of users of an urban area in need of social transformation (ZNTS). Qualitative methodology (exploratory study). Urban basic health zone (16,000 inhabitants, 40% ZNTS). Purposive sampling of users of SSPA and community leaders. Homogeneity criteria: age. Heterogeneity criteria: sex, frequency, active/pensioner, level cultural/economic. Conversational techniques recorded by videotape and moderated by a sociologist (user dicussion groups and in-depth interviews for community leaders). transcription of speeches, coding, categories triangulation and final outcome. Seven groups (43 participants, 58% ZNTS) and 6 leaders. They want continuity of care and choice of professionals, but not the medical change without information and attention's discontinuity primary care/hospital. There's bad physical accesibility by the urban environment in the ZNTS and is criticized admission services and paperwork; the programmed appointment and the electronic prescriptions are improvements but asking more hospital referrals and reviews. There's good appreciation of the professionals (primary care-closer, hospital-greater technical capacity). It needs to improve nursing education and speed of emergency assistance. There's a lack of leadership in the system organization, very fragmented. They know a range of services focusing on the demand for care; other health activities not spread to the users. The SSPA should incorporate the views and expectations of communities in social risk to a real improvement in the quality of care. Copyright © 2012 Elsevier España, S.L. All rights reserved.

Formative Evaluation for a Healthy Corner Store Initiative in Pitt County, North Carolina: Assessing the Rural Food Environment, Part 1

PubMed Central

Bringolf, Karamie R.; Lawton, Katherine K.; McGuirt, Jared T.; Wall-Bassett, Elizabeth; Morgan, Jo; Laska, Melissa Nelson; Sharkey, Joseph R.

2013-01-01

Introduction Obesity prevalence in the rural United States is higher than in urban or suburban areas, perhaps as a result of the food environment. Because rural residents live farther from supermarkets than their urban- and suburban-dwelling counterparts, they may be more reliant on smaller corner stores that offer fewer healthful food items. Methods As part of a Communities Putting Prevention to Work (CPPW) healthy corner store initiative, we reviewed audit tools in the fall of 2010 to measure the consumer food environment in eastern North Carolina and chose the NEMS-S-Rev (Nutrition Environment Measures Survey-Stores-Revised) to assess 42 food stores. During the spring and summer of 2011, 2 trained graduate assistants audited stores, achieving interrater reliability of at least 80%. NEMS-S-Rev scores of stores in rural versus urban areas were compared. Results Overall, healthful foods were less available and of lower quality in rural areas than in urban areas. NEMS-S-Rev scores indicated that healthful foods were more likely to be available and had similar pricing and quality in rural corner stores than in urban corner stores. Conclusion Food store audit data provided a baseline to implement and evaluate a CPPW healthy corner store initiative in Pitt County. This work serves as a case study, providing lessons learned for engaging community partners when conducting rural food store audits. PMID:23866165

The influence of loan repayment on rural healthcare provider recruitment and retention in Colorado.

PubMed

Renner, Daniel M; Westfall, John M; Wilroy, Lou Ann; Ginde, Adit A

2010-01-01

There is an ongoing shortage of rural healthcare providers relative to urban healthcare providers worldwide. Many strategies have been implemented to increase the distribution of rural healthcare providers, and financial incentives such as loan repayment programs have become popular means to both recruit and retain healthcare providers in rural communities. Studies detailing the effects of such programs on rural provider recruitment and retention are limited. The objective of this study was to assess the influence of loan repayment and other factors on the recruitment and retention of healthcare providers in rural Colorado, USA, and to compare the motivations and attitudes of these rural providers with their urban counterparts. A survey was sent to 122 healthcare providers who had participated in one of three loan repayment programs in Colorado between the years of 1992 and 2007: the Colorado Health Professional Loan Repayment Program; the Colorado Rural Outreach Program; and the Dental Loan Repayment Program of Colorado. Differentiation between rural and urban communities was accomplished by using the Rural Urban Commuting Area Codes developed by the University of Washington's Rural Health Research Center and Economic Research Service. Statistical analysis was performed using STATA from StataCorp. Of the 93 respondents included in the study, 57 worked in rural communities and 36 worked in urban communities during their programs. Of the rural participants, 74% were already working in or intending to work in an eligible community when they were made aware of the loan repayment program. Of those planning to work in a rural community regardless of any loan repayment option, 42% reported that the loan repayment program had an important influence on the specific community in which they chose to practice. Of the rural participants already working in a rural community, 38% reported loan repayment as being an important factor in their retention. The most important factors the rural providers cited for their recruitment were the location of the community, scope of practice, and family fit with the community. The most important factors for the urban providers were the location of the community, salary, and scope of practice. Of the rural providers, 36% attended rural high schools, while 9% of urban providers attended rural high schools. Of the rural providers who were planning on practicing in a rural area regardless of any loan repayment option, 37% had attended rural high schools. Rural participants most often left their communities because their families wanted to move, personal or professional isolation, and dissatisfaction with the medical community. Of rural participants 22% cited the desire for a higher income as an important reason to leave their communities, while the desire for a higher income was the most commonly cited reason for the urban providers. Rural retention rates were not influenced by past attendance at rural high schools or by intention to practice in a rural community regardless of loan repayment. Loan repayment programs targeting rural Colorado usually enroll providers who would have worked in a rural area regardless of loan repayment opportunities, but are likely to play a role in providers' choice of specific rural community for practice. They also appear to have a limited but important influence on rural provider retention, though financial concerns are generally less influential for non-retained rural providers than are family preferences and professional dissatisfaction.

Retention of female volunteer community health workers in Dhaka urban slums: a prospective cohort study.

PubMed

Alam, Khurshid; Oliveras, Elizabeth

2014-05-20

Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. BRAC, a large Bangladeshi non-governmental organization (NGO), has employed female volunteer CHWs in its community-based health programs since 1977, recently including its Manoshi project, a community-based maternal and child health intervention in the urban slums of Bangladesh. A case-control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. We used a prospective cohort study design to examine the factors affecting retention of volunteer CHWs who remained in the project after the initial start-up period. We surveyed a random sample of 542 CHWs who were working for BRAC Manoshi in December 2008. In December 2009, we revisited this cohort of CHWs and interviewed those who had dropped out about the main reasons for their dropping out. We used a multivariable generalized linear model regression analysis with a log link to estimate the relative risk (RR) of independent factors on retention. Of the 542 CHWs originally enrolled, 120 had dropped out by the end of one year, mainly because they left the slums. CHWs who received positive community appraisal (adjusted RR = 1.45, 95% confidence interval (CI) = 1.10 to 1.91) or were associated with other NGOs (adjusted RR = 1.13, 95% CI = 1.04 to 1.23) were more likely to have been retained in the project. Although refresher training was also associated with increased retention (adjusted RR = 2.25, 95% CI = 1.08 to 4.71) in this study, too few CHWs had not attended refresher training regularly to make it a meaningful predictor of retention that could be applied in the project setting. Factors that affect retention of CHWs may change over time, with some factors that are important in the early years of a project losing importance as the project matures. Community health programs operating in fragile urban slums should consider changing factors over program duration for better retention of volunteer CHWs.

Prevalence of Physical Activity Policies and Environmental Strategies in Communities and Worksites: The Iowa Community Transformation Grant.

PubMed

Lillehoj, Catherine J; Daniel-Ulloa, Jason D; Nothwehr, Faryle

2016-01-01

This study describes results of community and worksite assessments of physical activity policies and environmental strategies in 26 Iowa counties. Community coalition members completed the Community Health Assessment and Group Evaluation tool. The study explored findings using descriptive statistics and examined rural-urban differences in two of the five assessed sectors: community and worksites. Lower community scores (ie, needing improvement) were found for complete streets, bicycle use, and street calming. Higher scores (ie, identified strengths) were found for land use plans, maintain parks, and sidewalks Americans with Disabilities Act compliant. Worksites scored lower on promote stairwells, encourage non-motorized commuting, and implement activity breaks but higher on subsidize gym membership and provide area for physical activity. No rural-urban differences were found. Results identify opportunities to enhance community and worksite policies and environmental strategies to increase physical activity.

Urban renewal, gentrification and health equity: a realist perspective.

PubMed

Mehdipanah, Roshanak; Marra, Giulia; Melis, Giulia; Gelormino, Elena

2018-04-01

Up to now, research has focused on the effects of urban renewal programs and their impacts on health. While some of this research points to potential negative health effects due to gentrification, evidence that addresses the complexity associated with this relation is much needed. This paper seeks to better understand when, why and how health inequities arise from urban renewal interventions resulting in gentrification. A realist review, a qualitative systematic review method, aimed to better explain the relation between context, mechanism and outcomes, was used. A literature search was done to identify theoretical models of how urban renewal programs can result in gentrification, which in turn could have negative impacts on health. A systematic approach was then used to identify peer-reviewed studies that provided evidence to support or refute the initial assumptions. Urban renewal programs that resulted in gentrification tended to have negative health effects primarily in residents that were low-income. Urban renewal policies that were inclusive of populations that are vulnerable, from the beginning were less likely to result in gentrification and more likely to positively impact health through physical and social improvements. Research has shown urban renewal policies have significant impacts on populations that are vulnerable and those that result in gentrification can result in negative health consequences for this population. A better understanding of this is needed to impact future policies and advocate for a community-participatory model that includes such populations in the early planning stages.

[Study on effects of community-based management of hypertension patients aged ≥35 years and influencing factors in urban and rural areas of China, 2010].

PubMed

Zeng, X Y; Zhang, M; Li, Y C; Huang, Z J; Wang, L M

2016-05-01

To understand the effects of standardized community-based management of hypertension in urban and rural areas in China and related influencing factors. The study subjects were the hypertension patients aged ≥35 years who were recruited in 2011 from the participants of 2010 national chronic and non-communicable disease surveillance project. The hypertension patients were diagnosed in community health centers or higher level hospitals and included in community based hypertension management project. By face-to-face questionnaire survey and health examination, the information of the subjects' demographic characteristics, risk factors, complications, involvement in community-based management of hypertension, anti-hypertension treatment, blood pressure, body height, waistline and body weight were collected. In this study, Rao-Scott χ(2) test was used to compare the variations among sub-groups. Taylor series linearization method was used to estimate the prevalence rate. The complex sampling and unconditional multivariate logistics regression analysis was conducted to identify the influencing factors for the control of hypertension. A total of 5 120 subjects were recruited in the analysis. The proportion of those receiving management for more than two years was 36.57%, and it was higher in urban area(44.56%)than in rural area(31.79%, P<0.05); In the past 12 months, 6.17% and 14.46% of the patients received no blood pressure measurement and drug therapy advice respectively, but there were no significant differences between urban group and rural group(P>0.05); In the past 12 months, the proportions of the patients receiving diet and physical activity advice were 84.25% and 84.90% respectively, and the proportions were higher in urban group than in rural group(P<0.05); In the past 12 months, the proportions of the subjects receiving tobacco and alcohol use advice were 78.41% and 77.80% respectively, and the proportions were higher in rural group than in urban group(P<0.05). In urban area, the subjects receiving standardized management had lower SBP(142.79±17.39)mmHg, lower DBP(84.26±9.49)mmHg and higher blood pressure control rate(49.77%)than those receiving no standardized management(P<0.05); while in rural area, no difference was found in BP control between the patients receiving and receiving no standardized management(P>0.05). In urban area, the influencing factors for BP control among the subjects receiving community based management were educational level, annual income, body weight, hypertension management mode, times of receiving BP measurement, times of receiving antihypertensive medicine advice and receiving physical activity advice; while in rural area, the influencing factors for BP control among the subjects receiving community based management were annual income, body weight, family history of hypertension, antihypertensive medicine awareness, times of receiving antihypertensive medicine advice and receiving diet advice. The effects of community-based standardized management of hypertension were better in urban area than in rural area, and the quality of the services of community-based hypertension management was lower in rural area than in urban area.

Religious Congregations' Collaborations: With Whom Do They Work and What Resources Do They Share in Addressing HIV and Other Health Issues?

ERIC Educational Resources Information Center

Werber, Laura; Derose, Kathryn Pitkin; Dominguez, Blanca X.; Mata, Michael A.

2012-01-01

This study explores how religious congregations interact with other community organizations to address health and, in particular, HIV-related needs within their membership and/or local communities. Case study data from a diverse sample of 14 urban congregations (6 Black, 4 Latino, 2 White, and 2 mixed race-ethnicity) indicate that they engaged in…

Cognition and Context: Rural-Urban Differences in Cognitive Aging Among Older Mexican Adults.

PubMed

Saenz, Joseph L; Downer, Brian; Garcia, Marc A; Wong, Rebeca

2017-04-01

To describe differences in cognitive functioning across rural and urban areas among older Mexican adults. We include respondents aged 50+ in the 2012 Mexican Health and Aging Study (MHAS). Cognitive functioning by domain is regressed as a function of community size. The role of educational attainment in explaining rural/urban differences in cognitive functioning is examined. Respondents residing in more rural areas performed worse across five cognitive domains. The majority, but not all, of the association between community size and cognitive functioning was explained by lower education in rural areas. Respondents residing in more rural areas were disadvantaged in terms of cognitive functioning compared with those residing in more urban areas. Poorer cognitive functioning in late life may be the result of historical educational disadvantage in rural areas or selection through migration from rural to urban regions for employment.

'Picture me healthy': a pilot study using photovoice to explore health perceptions among migrant youth in Beijing, China.

PubMed

Leung, May May; Jun, Jing; Tseng, Anna; Bentley, Margaret

2017-09-01

Globalization has resulted in an influx of migrant families from rural provinces into the urban areas of China. Although the migrant population may live in the same cities as urban residents, they experience different lives because of restricted access to job opportunities, social services, and schools for children. Limited research exists with Chinese rural-to-urban migrant youth, particularly using community-based approaches. This study explored migrant youths' perceptions of their nutrition, physical activity, and health environment, using the community-based participatory research method of photovoice. Twelve migrant youth (6 boys and 6 girls) in Beijing, China, participated in two photovoice assignments focused on personal safety, nutrition, and physical activity. The photographs taken by the youth guided group discussions and semi-structured interviews. Inductive and deductive processes were used to identify codes (ideas emerging from text); similar codes were grouped into themes. Pedestrian safety was the most common personal safety concern. Another safety issue was the excess garbage in the community. Garbage was also a barrier to nutrition and physical activity as it was a food sanitation concern and limited the physical environments where children could play. Schools and community recreation centers were perceived as facilitators of physical activity. However, community centers were also a barrier as a limited number of them caused overcrowding, resulting in safety concerns. Photovoice enables youth to express their health perceptions. Our data provide interesting preliminary insight into the lives of Chinese migrant youth, which could help inform the development of interventions and advocate for positive environmental changes for this marginalized population.

Academic-practice collaboration in nursing education: service-learning for injury prevention.

PubMed

Alexander, Gina K; Canclini, Sharon B; Krauser, Debbie L

2014-01-01

Teams of senior-level baccalaureate nursing students at a private, urban university complete a population-focused public health nursing practicum through service-learning partnerships. Recently, students collaborated with local service agencies for Safe Communities America, a program of the National Safety Council in affiliation with the World Health Organization. This article describes the student-led process of community assessment, followed by systematic planning, implementation, and evaluation of evidence-based interventions to advance prescription drug overdose/poisoning prevention efforts in the community.

Benchmarking information needs and use in the Tennessee public health community*

PubMed Central

Lee, Patricia; Giuse, Nunzia B.; Sathe, Nila A.

2003-01-01

Objective: The objective is to provide insight to understanding public health officials' needs and promote access to data repositories and communication tools. Methods: Survey questions were identified by a focus group with members drawn from the fields of librarianship, public health, and informatics. The resulting comprehensive information needs survey, organized in five distinct broad categories, was distributed to 775 Tennessee public health workers from ninety-five counties in 1999 as part of the National Library of Medicine–funded Partners in Information Access contract. Results: The assessment pooled responses from 571 public health workers (73% return rate) representing seventy-two of ninety-five counties (53.4% urban and 46.6% rural) about their information-seeking behaviors, frequency of resources used, computer skills, and level of Internet access. Sixty-four percent of urban and 43% of rural respondents had email access at work and more than 50% of both urban and rural respondents had email at home (N = 289). Approximately 70% of urban and 78% of rural public health officials never or seldom used or needed the Centers for Disease Control (CDC) Website. Frequency data pooled from eleven job categories representing a subgroup of 232 health care professionals showed 72% never or seldom used or needed MEDLINE. Electronic resources used daily or weekly were email, Internet search engines, internal databases and mailing lists, and the Tennessee Department of Health Website. Conclusions: While, due to the small sample size, data cannot be generalized to the larger population, a clear trend of significant barriers to computer and Internet access can be identified across the public health community. This contributes to an overall limited use of existing electronic resources that inhibits evidence-based practice. PMID:12883562

The social accountability of doctors: a relationship based framework for understanding emergent community concepts of caring.

PubMed

Green-Thompson, Lionel P; McInerney, Patricia; Woollard, Bob

2017-04-12

Social accountability is defined as the responsibility of institutions to respond to the health priorities of a community. There is an international movement towards the education of health professionals who are accountable to communities. There is little evidence of how communities experience or articulate this accountability. In this grounded theory study eight community based focus group discussions were conducted in rural and urban South Africa to explore community members' perceptions of the social accountability of doctors. The discussions were conducted across one urban and two rural provinces. Group discussions were recorded and transcribed verbatim. Initial coding was done and three main themes emerged following data analysis: the consultation as a place of love and respect (participants have an expectation of care yet are often engaged with disregard); relationships of people and systems (participants reflect on their health priorities and the links with the social determinants of health) and Ubuntu as engagement of the community (reflected in their expectation of Ubuntu based relationships as well as part of the education system). These themes were related through a framework which integrates three levels of relationship: a central community of reciprocal relationships with the doctor-patient relationship as core; a level in which the systems of health and education interact and together with social determinants of health mediate the insertion of communities into a broader discourse. An ubuntu framing in which the tensions between vulnerability and power interact and reflect rights and responsibility. The space between these concepts is important for social accountability. Social accountability has been a concept better articulated by academics and centralized agencies. Communities bring a richer dimension to social accountability through their understanding of being human and caring. This study also creates the connection between ubuntu and social accountability and their mutual transformative capacity as agents for social justice.

Overcoming the hurdles to providing urban health care in the 21st century.

PubMed

Guerra, Fernando A; Crockett, Susan A

2004-12-01

The delivery of health care services to urban populations in the United States is a system of rapidly increasing complexity. With the emergence of superspecialized physicians, a scientific approach to disease management has received great emphasis. Those providing health care at the population level may also apply this evidence-based approach. Analysis of the process of health care delivery in its entirety is complicated, confusing, and may be fraught with bias. In this article, a powerful instrument for providing a scientific approach to urban health care health policy development is introduced. This tool allows for analysis and assessment of hurdles to health care delivery to urban populations by dividing the process into elements of "administration," "provision," and "utilization" (APU). This APU triangle model, while intuitive, also allows a more definitive analysis by parts than would be possible to make of the whole. Using this model, the authors explore some of the hurdles faced by each element as well as some potential solutions. Although this model is presented in the context of urban hurdles to health care, it is equally applicable to rural environments or other service-delivery systems. In conclusion, this article discusses the emergence of the role of the public health department as the facilitator and manager between sectors of the community not traditionally connected in a collaborative health care model. Thus, the urban public health department coordinates efforts to surmount the hurdles and provides the venue for analysis, development, and employment of successful strategies.

Exploring the Impacts of Housing Condition on Migrants’ Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach

PubMed Central

Xiao, Yang; Sarkar, Chinmoy; Geng, Huizhi

2018-01-01

Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers’ mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities. PMID:29382174

Exploring the Impacts of Housing Condition on Migrants' Mental Health in Nanxiang, Shanghai: A Structural Equation Modelling Approach.

PubMed

Xiao, Yang; Miao, Siyu; Sarkar, Chinmoy; Geng, Huizhi; Lu, Yi

2018-01-29

Although rapid urbanization and associated rural-to-urban migration has brought in enormous economic benefits in Chinese cities, one of the negative externalities include adverse effects upon the migrant workers' mental health. The links between housing conditions and mental health are well-established in healthy city and community planning scholarship. Nonetheless, there has thusfar been no Chinese study deciphering the links between housing conditions and mental health accounting for macro-level community environments, and no study has previously examined the nature of the relationships in locals and migrants. To overcome this research gap, we hypothesized that housing conditions may have a direct and indirect effects upon mental which may be mediated by neighbourhood satisfaction. We tested this hypothesis with the help of a household survey of 368 adult participants in Nanxiang Town, Shanghai, employing a structural equation modeling approach. Our results point to the differential pathways via which housing conditions effect mental health in locals and migrants. For locals, housing conditions have direct effects on mental health, while as for migrants, housing conditions have indirect effects on mental health, mediated via neighborhood satisfaction. Our findings have significant policy implications on building an inclusive and harmonious society. Upstream-level community interventions in the form of sustainable planning and designing of migrant neighborhoods can promote sense of community, social capital and support, thereby improving mental health and overall mental capital of Chinese cities.

The influence of nondisclosure on the mental health of urban African-American adolescents exposed to community violence.

PubMed

Dinizulu, Sonya Mathies; Grant, Kathryn E; McIntosh, Jeanne M

2014-01-01

African-American youth residing in urban poverty have been shown to be at increased risk for exposure to violence and internalizing symptoms, but there has been little investigation of moderating processes that might attenuate or exacerbate this association. The current study examined nondisclosure as a possible moderator of the association between community violence and internalizing symptoms with a sample of 152 low-income urban African-American early adolescents using hierarchical regression analyses. Results revealed that nondisclosure for relationship reasons (e.g., adults could not be trusted to provide needed support) moderated the association between exposure to community violence and internalizing symptoms. Unexpectedly, however, results of simple effects analyses revealed a stronger association between exposure to violence and internalizing symptoms for youth who disclosed more to adults. Although unexpected, this pattern builds upon prior research indicating that adult-child relationships are compromised within the context of urban poverty and that protective factors may lose their power under conditions of extreme stress.

Rural/Urban Differences in Child Growth and Survival in Bolivia.

ERIC Educational Resources Information Center

Heaton, Tim B.; Forste, Renata

2003-01-01

In Bolivia, a third of rural children are stunted, and rural infants are twice as likely to die before age 2 than urban infants. National survey data indicate child survival and development are related to maternal education and literacy, community sanitation practices, access to health care, and socioeconomic status. Parental knowledge about…

Urban Waters and the Caño Martín Peña (Martín Peña Channel, Puerto Rico)

EPA Pesticide Factsheets

The Martín Peña Channel Urban Waters Federal Partnership seeks to make significant contributions to the health and welfare of the eight communities that surround the Martín Peña Channel in San Juan, Puerto Rico.

A comparison of complementary and alternative medicine users and use across geographical areas: A national survey of 1,427 women

PubMed Central

2011-01-01

Background Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors. Methods A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009. Results The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas. Conclusion It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic. PMID:21981986

Adapting the botanical garden into a sustainable, multicultural resource

Treesearch

Susan Lacerte

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Urban malaria treatment behaviour in the context of low levels of malaria transmission in Lagos, Nigeria.

PubMed

Brieger, W R; Sesay, H R; Adesina, H; Mosanya, M E; Ogunlade, P B; Ayodele, J O; Orisasona, S A

2001-01-01

Urban malaria in West Africa is not well documented. While rapid urbanisation may create environmental conditions that favour mosquito breeding, urban pollution may inhibit the growth of Anopheles species. In 1996, the Basic Support for Institutionalizing Child Survival (BASICS) Project of the U.S. Agency for International Development (USAID) started building urban community health coalitions in Lagos, Nigeria, to empower communities to provide prompt treatment and appropriate prevention for major causes of childhood morbidity and mortality, including malaria, diarrhoeal disease, acute respiratory infections and vaccine preventable diseases. Intervention against malaria was predicated on national policies that assumed Nigeria was holo-endemic for malaria and that prompt treatment of febrile illness with anti-malarial drugs was an appropriate action. At the suggestion and with the assistance of another USAID programme, the Environmental Health Project (EHP), BASICS embarked on a rapid assessment of the epidemiological, entomological and sociological situation of malaria transmission and case management in three Lagos communities. During April and May 1998, blood film investigation of 916 children between the ages of 6 months and 5 years yielded a parasite prevalence rate of 0.9%. Night knockdown collections of mosquitoes in rooms yielded only C. quinquefasciatus and A. aegypti. The same results were obtained for night landing collections on human bait. Very low densities of A. gambiae larvae were found in breeding sites in Lagos Island (0.7) and Ajegunle (0.3). In contrast, community members, during focus group discussion identified malaria, in it various culturally defined forms, as a major health problem. Among the children examined clinically, 186 (20.3%) reported an illness, which they called "malaria" in the previous two weeks, and 180 had sought treatment for this illness. Data obtained from 303 shops in the area documented that a minimum of US dollars 4,000 was spent on purchases of anti-malarial drugs in the previous week. The implications of these findings for both professional and community education are discussed.

Equity, sustainability and governance in urban settings.

PubMed

Rice, Marilyn; Hancock, Trevor

2016-03-01

In this commentary the urban setting is explored from the perspective of ecological sustainability and social equity. Urban-related issues are highlighted related to social inequality, deficits in urban infrastructures, behavior-related illnesses and risks, global ecological changes, and urban sprawl. Approaches to addressing these issues are described from the perspective of urban governance, urban planning and design, social determinants of health, health promotion, and personal and community empowerment. Examples of successful strategies are provided from Latin America, including using participatory instruments (assessments, evaluation, participatory budgeting, etc.), establishing intersectoral committees, increasing participation of civil society organizations, and developing virtual forums and networks to channel participatory and collaborative processes. A way forward is proposed, using the urban setting to show the imperative of creating intersectoral policies and programs that produce environments that are both healthy and sustainable. It will be important to include new forms of social participation and use social media to facilitate citizen decision-making and active participation of all sectors of society, especially excluded groups. © The Author(s) 2015.

When the dragon's awake: a needs assessment of people injecting drugs in a small urban centre.

PubMed

Gustafson, Diana L; Goodyear, Lesley; Keough, Fran

2008-06-01

St. John's, Newfoundland and Labrador is one of the smallest Canadian provincial capitals. Like other Canadian coastal communities, St. John's has been affected by dramatic economic and institutional restructuring that negatively impacted community health. Marginalized populations including people who inject drugs are more negatively affected by the gap between health needs and available services. A mixed methods needs assessment began with a survey and key informant and focus group interviews to determine attitudes, knowledge, and practices of people with current or previous experience injecting drugs. An environmental scan of programmes and services was conducted followed by a community consultation with key stakeholders, community agencies, study participants, the media, and members of the public to share and validate findings, solicit feedback, and gather data about future knowledge transfer activities. This paper examines two of the five barriers to health and health services for people injecting drugs: First, there was a discrepancy amongst people injecting drugs between awareness and use of safer practices, and second, there was a limited formalized network of health and social programmes and services. Accurate and timely information about safer practices, whilst an essential component of a harm reduction approach, is insufficient to reduce the risk of negative health outcomes for people injecting drugs. Funding new programmes and services, although desirable, is not always feasible in small urban centres with limited human and material resources. Recommendations for promoting health, reducing harm, and building local capacity must consider these limitations. Registered nurses are well positioned to provide leadership through collaborative community-based research, education and advocacy.

Community leadership competencies in the Northeast US: implications for training public health educators.

PubMed Central

Strand, G A

1981-01-01

A survey was conducted to determine leadership competencies as perceived by 679 community residents (urban/rural) in six states of the Northeast United States. Respondents were asked to rate the extent to which it is important for a community leader to use each competency listed in the instrument. A factor analysis reduced the list of 39 competency items examined into nine distinct factors. Alpha internal consistency estimates revealed the strength of correlation among items in each factor. A series of one-way analyses of variance failed to show a significant difference between urban/rural community respondents' scores for each factor. The findings suggest specific leadership competencies which should be emphasized in training experiences. Conceptual competencies were identified as most important (problem delineation, organization, management of change, etc.), followed by human competencies (demeanor, empathy, attitudes) and technical competencies (budgeting, supervision, needs assessment) respectively. Items within each factor have implications for development of specific content areas in a leadership training curriculum for public health educators. PMID:7468880

Reaping the harvest: nursing student service involvement with a campus gardening project.

PubMed

Ahonen, Kathleen; Lee, Carolyn; Daker, Emily

2012-01-01

The authors describe the development and incorporation of a multidisciplinary community garden as a service project in a baccalaureate nursing cohort in an urban university. The concepts of professional ethics and service, application of nutritional theory to a community cohort, and competencies in community health nursing are briefly discussed and applied to this service project.

Household and community socioeconomic influences on early childhood malnutrition in Africa.

PubMed

Fotso, Jean-Christophe; Kuate-Defo, Barthelemy

2006-05-01

This paper uses multilevel modelling and Demographic and Health Survey data from five African countries to investigate the relative contributions of compositional and contextual effects of socioeconomic status and place of residence in perpetuating differences in the prevalence of malnutrition among children in Africa. It finds that community clustering of childhood malnutrition is accounted for by contextual effects over and above likely compositional effects, that urban-rural differentials are mainly explained by the socioeconomic status of communities and households, that childhood malnutrition occurs more frequently among children from poorer households and/or poorer communities and that living in deprived communities has an independent effect in some instances. This study also reveals that socioeconomic inequalities in childhood malnutrition are more pronounced in urban centres than in rural areas.

Perspectives of Urban Corner Store Owners and Managers on Community Health Problems and Solutions

PubMed Central

Young, Candace R.; Cannuscio, Carolyn C.; Karpyn, Allison; Kounaves, Sarah; Strupp, Emily; McDonough, Kevin; Shea, Judy A.

2016-01-01

Introduction Urban corner store interventions have been implemented to improve access to and promote purchase of healthy foods. However, the perspectives of store owners and managers, who deliver and shape these interventions in collaboration with nonprofit, government, and academic partners, have been largely overlooked. We sought to explore the views of store owners and managers on the role of their stores in the community and their beliefs about health problems and solutions in the community. Methods During 2013 and 2014, we conducted semistructured, in-depth interviews in Philadelphia, Pennsylvania, and Camden, New Jersey, with 23 corner store owners/managers who participated in the Healthy Corner Store Initiative spearheaded by The Food Trust, a nonprofit organization focused on food access in low-income communities. We oversampled high-performing store owners. Results Store owners/managers reported that their stores served multiple roles, including providing a convenient source of goods, acting as a community hub, supporting community members, working with neighborhood schools, and improving health. Owners/managers described many challenging aspects of running a small store, including obtaining high-quality produce at a good price and in small quantities. Store owners/managers believed that obesity, diabetes, high cholesterol, and poor diet are major problems in their communities. Some owners/managers engaged with customers to discuss healthy behaviors. Conclusion Our findings suggest that store owners and managers are crucial partners for healthy eating interventions. Corner store owners/managers interact with community members daily, are aware of community health issues, and are community providers of access to food. Corner store initiatives can be used to implement innovative programs to further develop the untapped potential of store owners/managers. PMID:27736054

Perspectives of Urban Corner Store Owners and Managers on Community Health Problems and Solutions.

PubMed

Mayer, Victoria L; Young, Candace R; Cannuscio, Carolyn C; Karpyn, Allison; Kounaves, Sarah; Strupp, Emily; McDonough, Kevin; Shea, Judy A

2016-10-13

Urban corner store interventions have been implemented to improve access to and promote purchase of healthy foods. However, the perspectives of store owners and managers, who deliver and shape these interventions in collaboration with nonprofit, government, and academic partners, have been largely overlooked. We sought to explore the views of store owners and managers on the role of their stores in the community and their beliefs about health problems and solutions in the community. During 2013 and 2014, we conducted semistructured, in-depth interviews in Philadelphia, Pennsylvania, and Camden, New Jersey, with 23 corner store owners/managers who participated in the Healthy Corner Store Initiative spearheaded by The Food Trust, a nonprofit organization focused on food access in low-income communities. We oversampled high-performing store owners. Store owners/managers reported that their stores served multiple roles, including providing a convenient source of goods, acting as a community hub, supporting community members, working with neighborhood schools, and improving health. Owners/managers described many challenging aspects of running a small store, including obtaining high-quality produce at a good price and in small quantities. Store owners/managers believed that obesity, diabetes, high cholesterol, and poor diet are major problems in their communities. Some owners/managers engaged with customers to discuss healthy behaviors. Our findings suggest that store owners and managers are crucial partners for healthy eating interventions. Corner store owners/managers interact with community members daily, are aware of community health issues, and are community providers of access to food. Corner store initiatives can be used to implement innovative programs to further develop the untapped potential of store owners/managers.

Adolescent and parent use of new technologies for health communication: a study in an urban latino community.

PubMed

Smaldone, Arlene; Stockwell, Melissa S; Osborne, Jennel C; Cortes, Yamnia; Bekele, ElShadey; Green, Nancy S

2015-02-20

Mobile communication technologies provide novel opportunities to support clinic-based health initiatives. Adoption of technologies for daily use and for health communication can differ between communities, depending upon demographic and cultural characteristics. A survey was administered in adolescent primary care and subspecialty clinics to assess parent-adolescent preferences in use of mobile technologies and social media to support provider-patient communication in an urban Latino community. Of 130 respondents (65 parent-adolescent pairs), approximately half frequently sent and received text messages but lacked agreement regarding the other's text messaging use. In contrast, adolescents only rarely used email compared to parents (15.4% versus 37.5%, P=0.006). Of social media, Facebook™/MySpace™ was most frequently used by parents and youth (60% and 55.4%, P=0.59); however, most lacked interest in using social media for health communication. Parents reported more interest than adolescents in receiving email (73.4% versus 35.9%, P<0.001) and text messages (58.5% versus 33.9%, P=0.005) for health, but had more concerns about privacy issues (26.2% versus 9.2%, P=0.01). Respondents who were American born (aOR 5.7, 95%CI 1.2-28.5) or regularly used Instant Messaging or Facebook™/MySpace™ (aOR 4.6, 95%CI 1.4-14.7) were more likely to be interested in using social media for health communication. These findings underscore the importance of targeted assessment for planning the utilization of communication technologies and social media in clinical care or research for underserved youth. Significance for public healthCommunication technologies provide novel opportunities to support clinic-based health initiatives for underserved youth. However, adoption of technologies among communities may differ depending upon demographic and cultural characteristics. We surveyed a sample of urban Latino parents and youth regarding their current use of mobile and social media technologies and preferences for use of these technologies for health communication. This is the first study to compare the perspective of underserved parents and their youth regarding use of a wide variety of mobile and social communication technologies, concordance between youth-parent pairs in perceived use of texting and preferences for the purpose of health communication. Our findings differ from those from adults surveyed in other under-served communities, highlighting heterogeneity between communities. Variations in use of communication technologies and social media and preferences between parent-youth pairs suggest that understanding these factors within target populations is crucial for successful use to support health and health services.

Health Promotion in the Community: Impact of Faith-Based Lay Health Educators in Urban Neighborhoods.

PubMed

Galiatsatos, Panagis; Sundar, Siddhi; Qureshi, Adil; Ooi, Gavyn; Teague, Paula; Daniel Hale, W

2016-06-01

Promoting wellness and providing reliable health information in the community present serious challenges. Lay health educators, also known as community health workers, may offer a cost-effective solution to such challenges. This is a retrospective observational study of graduates from the Lay Health Educator Program (LHEP) at Johns Hopkins Bayview Medical Center from 2013 to 2014. Students were enrolled from the surrounding community congregations and from the hospital's accredited clinical pastoral education program. There were 50 events implemented by the lay health educators during the 2014-2015 time period, reaching a total of 2004 individuals. The mean time from date of graduation from the LHEP to implementation of their first health promotional event was 196 ± 76 days. A significant number of lay health educators implemented events within the first year after completing their training. Ongoing monitoring of their community activity and the clinical impact of their efforts should be a priority for future studies.

Population Density and Alcohol-Related Risk Behaviors among US High School Students

ERIC Educational Resources Information Center

Greggo, Jennifer; Jones, Sherry Everett; Kann, Laura

2005-01-01

By better understanding differences in health-risk behaviors among youth in rural, suburban and urban communities, health educators and other public health practitioners can more appropriately focus prevention and health care programs. In this study, we examined data from the national Youth Risk Behavior Survey (YRBS) to determine whether…

Health Careers Education for Rural Primary Schoolchildren

ERIC Educational Resources Information Center

Gorton, Susan M.

2011-01-01

International and national studies have reported that health professionals who grew up in a rural area are more likely to return to work in a rural area than their urban raised counterparts. The chronic severe shortage of health professionals in rural and remote Australia has meant inequitable health care for rural and remote communities and a…

The menthol marketing mix: targeted promotions for focus communities in the United States.

PubMed

Cruz, Tess Boley; Wright, La Tanisha; Crawford, George

2010-12-01

This study analyzes tobacco industry menthol marketing strategies aimed at urban predominantly Black populations. Data are drawn from an interview with a former Brown & Williamson Tobacco Company trade marketing manager, tobacco industry documents on Kool promotions in urban areas, and public health literature on tobacco marketing. Tobacco companies recognize the growth potential for the menthol segment in these urban communities. They have higher levels of price discounts and signage, exert tight controls over the retail environment, and use hip-hop lifestyle to associate menthol products with urban nightlife, music, fame, and cultural edginess among younger smokers. Tobacco companies regard the urban Black menthol segment as one of the few markets in which they can grow sales despite declines elsewhere in the United States. Consequently, this population is surrounded by intense and integrated levels of marketing. We need strong monitoring, regulation, and enforcement efforts that will counter the industry's use of menthol at multiple levels in urban environments.

Rural youth violence: it is a public health concern!

PubMed

Kulig, Judith C; Nahachewsky, Deana; Hall, Barry L; Kalischuk, Ruth Grant

2005-01-01

Youth violence is a significant issue for public health because of the potential for long-term impacts on individuals, families and communities. Limited exposure to violence is seen as a component of healthy living. However, there is limited understanding of violence from a public health perspective within rural communities. Rural refers to those communities with a population less than 10,000 outside the main commuting zone of a large urban area. Population health approaches, including the social determinants of health, are well supported by public health officials. Generating information about rural youth violence from a Canadian perspective would add to our understanding of these social determinants while providing guidance for policy and program development. Current understandings of youth violence are limited to an urban, and oftentimes, American perspective. An ongoing two-phase Canadian study on rural youth violence included qualitative interviews with 52 youth and the completion of a questionnaire that had been developed from the qualitative responses. The questionnaire has been completed by a larger sample of rural youth. The findings generated from this ongoing study will be useful in linking violence with social factors that impact health and thereby guide population health programs and policies. In this way, the role of public health to develop policies and implement programs will be directly influenced by evidence while addressing an ongoing public health concern.

The pattern of psychiatric morbidity in a Victorian urban aboriginal general practice population.

PubMed

McKendrick, J; Cutter, T; Mackenzie, A; Chiu, E

1992-03-01

Victorian Aboriginal people, most of whom live an urban lifestyle, form a distinct cultural group within the wider Victorian community. This paper describes a unique psychosocial study of urban Aboriginal adults attending a general practitioner at the Victorian Aboriginal Health Service in Fitzroy. The frequency and nature of psychiatric disorders among survey respondents is reported, together with a discussion of the association between this morbidity and certain sociodemographic variables.

Job satisfaction: rural versus urban primary health care workers' perception in Ogun State of Nigeria.

PubMed

Campbell, P C; Ebuehi, O M

2011-01-01

Job satisfaction implies doing a job one enjoys, doing it well, and being suitably rewarded for one' efforts. Several factors affect job satisfaction. To compare factors influencing job satisfaction amongst rural and urban primary health care workers in southwestern Nigeria. A cross sectional comparative study recruited qualified health workers selected by multi stage sampling technique from rural and urban health facilities in four local government areas (LGAs) of Ogun State in Southwestern Nigeria. Data were collected and analysed using Epi info V 3.5.1 RESULTS: The response rates were 88(88%) and 91(91%) respectively in the rural and urban areas. While urban workers derived satisfaction from availability of career development opportunities, materials and equipment, in their current job, rural workers derived satisfaction from community recognition of their work and improved staff relationship. Major de-motivating factors common to both groups were lack of supportive supervision, client-provider relationship and lack of in-service training. However more rural 74(84.1%) than urban 62(68.1%) health workers would prefer to continue working in their present health facilities (p=0.04). There was a statistically significant difference between the two groups in job satisfaction with respect to tools availability and career development opportunities (p<0.05). There is dissimilarity in factors influencing job satisfaction between rural and urban healthcare workers. There is need for human resource policy to be responsive to the diverse needs of health workers particularly at the primary level.

The development of urban community health centres for strengthening primary care in China: a systematic literature review.

PubMed

Wang, Harry H X; Wang, Jia Ji; Wong, Samuel Y S; Wong, Martin C S; Mercer, Stewart W; Griffiths, Sian M

2015-01-01

This review outlines the development of China's primary care system, with implications for improving equitable health care. Government documents, official statistics, and recent literature identified through systematic searches performed on NCBI PubMed. Community health centres (CHCs) are being developed as the major primary care provider in urban China, with laudable achievements. The road towards a strong primary care-led system is promising but challenging. The effectiveness in improving equitable care through the expansion of primary care workforce and redesign of the social medical insurance system warrants further exploration. Healthcare disparities exist in the health system wherein universal health coverage and gatekeepers have not yet been established. Future prospective studies should aim to provide solutions for strengthening the leading role of CHCs in providing equitable care in response to population ageing and multimorbidity challenges. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Perceptions of the community food environment and related influences on food choice among midlife women residing in rural and urban areas: a qualitative analysis.

PubMed

Jilcott, Stephanie B; Laraia, Barbara A; Evenson, Kelly R; Ammerman, Alice S

2009-01-01

Qualitative research on food choice has rarely focused on individuals' perceptions of the community food environment. Women remain gatekeepers of the family diet and food purchasing. Therefore we assessed midlife, Southern women's perceptions of the food environment. Related influences on food choices at work and at home were also examined. We recruited 28 low- and moderate-income, midlife (37-67 years) women from rural and urban areas of southeastern North Carolina, using typical case and snowball sampling. They responded to questions about multilevel influences on food choice in semi-structured, in-depth interviews. Women perceived differences between urban and rural food environments, with rural areas having fewer supermarkets and fast food restaurants compared to urban areas, which had fewer produce stands. Workplace food choices were affected by the social environment (co-workers), personal health concerns, and the surrounding food environment. Food chosen at home was primarily influenced by family members, health concerns, and convenient food sources. While future studies should explore findings in more representative populations, potential intervention strategies can be inferred, including emphasizing healthful aspects of the food environment. Intervention and advocacy efforts are needed to improve aspects of the food environment that make healthy choices difficult.

Urban versus rural health impacts attributable to PM2.5 and O3 in northern India

NASA Astrophysics Data System (ADS)

Karambelas, Alexandra; Holloway, Tracey; Kinney, Patrick L.; Fiore, Arlene M.; DeFries, Ruth; Kiesewetter, Gregor; Heyes, Chris

2018-06-01

Ambient air pollution in India contributes to negative health impacts and early death. Ground-based monitors often used to quantify health impacts are located in urban regions, yet approximately 70% of India’s population lives in rural communities. We simulate high-resolution concentrations of fine particulate matter (PM) and ozone from the regional Community Multi-scale Air Quality model over northern India, including updated estimates of anthropogenic emissions for transportation, residential combustion and location-based industrial and electrical generating emissions in a new anthropogenic emissions inventory. These simulations inform seasonal air quality and health impacts due to anthropogenic emissions, contrasting urban versus rural regions. For our northern India domain, we estimate 463 200 (95% confidence interval: 444 600–482 600) adults die prematurely each year from PM2.5 and that 37 800 (28 500–48 100) adults die prematurely each year from O3. This translates to 5.8 deaths per 10 000 attributable to air pollution out of an annual rate of 72 deaths per 10 000 (8.1% of deaths) using 2010 estimates. We estimate that the majority of premature deaths resulting from PM2.5 and O3 are in rural (383 600) as opposed to urban (117 200) regions, where we define urban as cities and towns with populations of at least 100 000 people. These findings indicate the need for rural monitoring and appropriate health studies to understand and mitigate the effects of ambient air pollution on this population in addition to supporting model evaluation.

The China Health and Nutrition Survey, 1989-2011.

PubMed

Zhang, B; Zhai, F Y; Du, S F; Popkin, B M

2014-01-01

The China Health and Nutrition Survey (CHNS) began in 1989 with the goal of creating a multilevel method of data collection from individuals and households and their communities to understand how the wide-ranging social and economic changes in China affect a wide array of nutrition and health-related outcomes. Initiated with a partial sample in 1989, the full survey runs from 1991 to 2011, and this issue documents the CHNS history. The CHNS cohort includes new household formation and replacement communities and households; all household members are studied. Furthermore, in-depth community data are collected. The sample began with eight provinces and added a ninth, Heilongjiang, in 1997 and three autonomous cities, Beijing, Shanghai, and Chongqing, in 2011. The in-depth community contextual measures have allowed us to create a unique measure of urbanicity that captures major dimensions of modernization across all 288 communities currently in the CHNS sample. The standardized, validated urbanicity measure captures the changes in 12 dimensions: population density; economic activity; traditional markets; modern markets; transportation infrastructure; sanitation; communications; housing; education; diversity; health infrastructure; and social services. Each is based on numerous measures applicable to each dimension. They are used jointly and separately in hundreds of studies. © 2014 The Authors. Obesity Reviews published by John Wiley & Sons Ltd on behalf of the International Association for the Study of Obesity.

Creating an Adolescent Health Promotion Internet Site. A Community Partnership between University Nursing Students and an Inner-City High School.

ERIC Educational Resources Information Center

Huyhn, Kim; Kosmyna, Bonnie; Lea, Holly; Munch, Krista R.; Reynolds, Heather S.; Specht, Corey; Tinker, Elizabeth C.; Yee, Anne Jezzamine; French, Laura R.

2000-01-01

Nursing students collaborated with urban high school students to identify adolescent health needs and to build and maintain a health information Web site. Student empowerment and ownership of the project were the keys to its sustainability. (SK)

Sexual orientation disparities in substance misuse: the role of childhood abuse and intimate partner violence among patients in care at an urban community health center.

PubMed

Reisner, Sari L; Falb, Kathryn L; Wagenen, Aimee Van; Grasso, Chris; Bradford, Judith

2013-02-01

This study examined disparities in lifetime substance misuse by sexual orientation among 2,653 patients engaged in care at an urban community health center in Boston, MA, as well as the potential mediating roles of childhood abuse

Relationship of household food insecurity to health-related quality of life in a large sample of rural and urban women.

PubMed

Sharkey, Joseph R; Johnson, Cassandra M; Dean, Wesley R

2011-07-22

The authors examined the associations of household food insecurity and other characteristics with fair-to-poor general health, poor physical health, and frequent mental distress among 1,367 rural and urban women in Texas. The 2006 Brazos Valley Community Health Assessment provided data on demographic characteristics, economic risk factors, health-related quality of life, household food insecurity, and geographic residence. Multivariable logistic regression models were estimated for the three health-related quality of life measures: fair-to-poor health, poor physical health, and frequent mental distress, adjusting for confounding variables. Having less than 12 years of education, not being employed full-time, and being household food insecure were independently significantly associated with increased odds for all health-related quality of life outcomes. Rural residence and being nonwhite were associated with fair-to-poor general health, but not physical or mental health. Results from the separate urban and rural models indicated that household food insecurity was associated with fair-to-poor general health among rural women, not among urban women. Poverty and being nonwhite were also associated with increased odds of reporting fair-to-poor general health, but were significant only among urban women. These results emphasize the need for health promotion and policy efforts to consider household food access and availability as part of promoting healthful food choices and good physical and mental health among women, especially rural women.

'Yarning up with Koori kids' - hearing the voices of Australian urban Indigenous children about their health and well-being.

PubMed

Priest, Naomi; Thompson, Laura; Mackean, Tamara; Baker, Alison; Waters, Elizabeth

2017-12-01

Australian Indigenous children experience some of the most substantial health inequalities globally. In this context, research regarding their health and well-being has overemphasised physical illnesses with limited exploration of a diverse range of dimensions and determinants, particularly those based on Indigenous holistic understandings of health and well-being. This deficit-based approach has thus missed many strengths and assets of Indigenous children. This research aimed to gain insight into the perspectives of Indigenous children about their health and well-being in an urban setting in Australia. It joins a limited international literature examining views and experiences of non-majority children. Participatory and qualitative child-friendly research methods were utilised. The project was developed in partnership with Indigenous community organisations and members. Photo-elicitation activities and focus groups were conducted with 31 Indigenous children aged 8-12 years. Qualitative data were analysed thematically, combining focus group and interview data. It was evident an urban Indigenous child perspective of health and well-being includes rich understandings of the interconnectedness of physical, social-emotional and cultural dimensions of holism, as well as the integral importance of family and community relationships. The study also found that specific worries regarding loss of loved ones and racism were highly salient in Indigenous children's lives. The overwhelming conclusion to be drawn from this research is that Indigenous children in urban areas need ongoing recognition of both their agency and resilience in the face of adversity, within a wider context of historical and contemporary racialisation and racism.

NIEHS/EPA CEHCs: Southern Center on Environmentally-Driven Disparities in Birth Outcomes (SCEDDBO) - University of Michigan and Duke University

EPA Pesticide Factsheets

The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

Restoring lives, transforming landscapes: the greenhouse program at Rikers Island jail

Treesearch

James Jiler

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Re-naturing the city: a role for sustainable infrastructure and buildings

Treesearch

Hillary Brown

2009-01-01

One of 18 articles inspired by the Meristem 2007 Forum, "Restorative Commons for Community Health." The articles include interviews, case studies, thought pieces, and interdisciplinary theoretical works that explore the relationship between human health and the urban...

Urban planning and health equity.

PubMed

Northridge, Mary Evelyn; Freeman, Lance

2011-06-01

Although the fields of urban planning and public health share a common origin in the efforts of reformers to tame the ravages of early industrialization in the 19th century, the 2 disciplines parted ways in the early 20th century as planners increasingly focused on the built environment while public health professionals narrowed in on biomedical causes of disease and disability. Among the unfortunate results of this divergence was a tendency to discount the public health implications of planning decisions. Given increasingly complex urban environments and grave health disparities in cities worldwide, urban planners and public health professionals have once again become convinced of the need for inclusive approaches to improve population health and achieve health equity. To make substantive progress, intersectoral collaboration utilizing ecological and systems science perspectives will be crucial as the solutions lie well beyond the control of any single authority. Grounded in the social determinants of health, and with a renewed sense of interconnectedness, dedicated and talented people in government agencies and communities who recognize that our future depends on cultivating local change and evaluating the results can come to grips with the enormous challenge that lies ahead to create more equitable, sustainable, and healthier cities worldwide.

Development of a multimetric index based on benthic macroinvertebrates for the assessment of urban stream health in Jinan City, China.

PubMed

Liu, Linfei; Xu, Zongxue; Yin, Xuwang; Li, Fulin; Dou, Tongwen

2017-05-01

Assessment of the health of urban streams is an important theoretical and practical topic, which is related to the impacts of physiochemical processes, hydrological modifications, and the biological community. However, previous assessments of the urban water quality were predominantly conducted by measuring physical and chemical factors rather than biological monitoring. The purpose of this study was to develop an urban stream multimetric index (USMI) based on benthic macroinvertebrates to assess the health of aquatic ecosystem in Jinan City. Two hundred and eighty-eight samples were collected during two consecutive years (2014-2015) from 48 sites located within the city. Metrics related to the benthic macroinvertebrate richness, diversity, composition and abundance, and functional feeding groups were selected by using box-plots and the Kruskal-Wallis test. The final index derived from selected metrics was divided into five river quality classes (excellent, good, moderate, poor, and bad). A validation procedure using box-plots and the non-parametric Mann-Whitney U test showed that the USMI was useful to assess the health of urban streams.

Google It!: Urban Community College Students' Use of the Internet to Obtain Self-Care and Personal Health Information

ERIC Educational Resources Information Center

Rennis, Lesley; McNamara, Gloria; Seidel, Erica; Shneyderman, Yuliya

2015-01-01

Background: As electronic resources increasingly play a major role in consumer health, eHealth literacy has emerged as a valuable tool to improve and enhance health knowledge and behavior. Yet for some populations, access to health information alone does not lead to better health practices or outcomes. Low income populations increasingly rely on…

Sociostructural factors influencing health behaviors of urban African-American men.

PubMed

Plowden, Keith O; Young, Anthony E

2003-06-01

African-American men are suffering disproportionately from most illnesses. Seemingly, action is needed if health disparities that disproportionately affect African-American men as compared to their White and female counterparts are to be reduced or eliminated. An important step in decreasing common health disparities evidenced among African-American men is to understand social factors that act as motivators and barriers to seeking care for most of this vulnerable population. Following a constructionist epistemology, this study used ethnography to explore social structure factors that motivate urban African-American men to seek care. Leininger's Culture Care Diversity and Universality Theory guided this study. Qualitative interviews were conducted with urban African-American men and other individuals in the community to explore understanding, attitudes, and beliefs about health. Critical issues examined included social factors associated with health seeking behaviors. Themes that emerged from these data indicated that critical social factors include: 1) Kinship/significant others; 2) accessibility of resources; 3) ethnohealth belief; and 4) accepting caring environment. The data also indicated a relationship between these social factors and health seeking behaviors of urban African-American men.

Evolution of an academic–public library partnership*

PubMed Central

Engeszer, Robert J.; Olmstadt, William; Daley, Jan; Norfolk, Monique; Krekeler, Kara; Rogers, Monica; Colditz, Graham; Anwuri, Victoria V.; Morris, Scott; Voorhees, Mychal; McDonald, Brenda; Bernstein, Jackie; Schoening, Paul; Williams, Lee

2016-01-01

A partnership to improve access to health information via an urban public library system was established in St. Louis, Missouri, in 2011. A multiyear project was outlined that included an information needs assessment, a training class for public library staff, information kiosks at library branches for delivering printed consumer health materials, and a series of health-related programming. The partnership evolved to include social service and community organizations to carry out project goals and establish a sustainable program that met the health and wellness interests of the community. PMID:26807055

Effects of landscape anthropization on mosquito community composition and abundance

NASA Astrophysics Data System (ADS)

Ferraguti, Martina; Martínez-de La Puente, Josué; Roiz, David; Ruiz, Santiago; Soriguer, Ramón; Figuerola, Jordi

2016-07-01

Anthropogenic landscape transformation has an important effect on vector-borne pathogen transmission. However, the effects of urbanization on mosquito communities are still only poorly known. Here, we evaluate how land-use characteristics are related to the abundance and community composition of mosquitoes in an area with endemic circulation of numerous mosquito-borne pathogens. We collected 340 829 female mosquitoes belonging to 13 species at 45 localities spatially grouped in 15 trios formed by 1 urban, 1 rural and 1 natural area. Mosquito abundance and species richness were greater in natural and rural areas than in urban areas. Environmental factors including land use, vegetation and hydrological characteristics were related to mosquito abundance and community composition. Given the differing competences of each species in pathogen transmission, these results provide valuable information on the transmission potential of mosquito-borne pathogens that will be of great use in public and animal health management by allowing, for instance, the identification of the priority areas for pathogen surveillance and vector control.

Effects of landscape anthropization on mosquito community composition and abundance

PubMed Central

Ferraguti, Martina; Martínez-de la Puente, Josué; Roiz, David; Ruiz, Santiago; Soriguer, Ramón; Figuerola, Jordi

2016-01-01

Anthropogenic landscape transformation has an important effect on vector-borne pathogen transmission. However, the effects of urbanization on mosquito communities are still only poorly known. Here, we evaluate how land-use characteristics are related to the abundance and community composition of mosquitoes in an area with endemic circulation of numerous mosquito-borne pathogens. We collected 340 829 female mosquitoes belonging to 13 species at 45 localities spatially grouped in 15 trios formed by 1 urban, 1 rural and 1 natural area. Mosquito abundance and species richness were greater in natural and rural areas than in urban areas. Environmental factors including land use, vegetation and hydrological characteristics were related to mosquito abundance and community composition. Given the differing competences of each species in pathogen transmission, these results provide valuable information on the transmission potential of mosquito-borne pathogens that will be of great use in public and animal health management by allowing, for instance, the identification of the priority areas for pathogen surveillance and vector control. PMID:27373794

Seeking systemic change: risk and protective factors affecting low-income urban youth.

PubMed

Meyerson, David A; Grant, Kathryn E

2014-01-01

This themed issue presents five articles tackling the topic of risk and protective processes affecting children and adolescents living in urban poverty. Through their research, the authors seek understanding of the particular challenges that low-income urban youth face, with the ultimate goal of understanding how best to intervene at various levels of the ecological system. Within this broad theme, studies examine specific stressors, mediators, and moderators that impact the mental health of youth living in urban poverty. The final article presents a data-driven, community-based intervention for this population.

Community-Based Health and Exposure Study around Urban Oil Developments in South Los Angeles

PubMed Central

Shamasunder, Bhavna; Collier-Oxandale, Ashley; Blickley, Jessica; Sadd, James; Chan, Marissa; Navarro, Sandy; Hannigan, Michael; Wong, Nicole J.

2018-01-01

Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil production sites in Los Angeles. We tested the capacity of low-cost sensors for localized exposure estimates. Bilingual surveys of 205 randomly sampled residences were collected within two 1500 ft. buffer areas (West Adams and University Park) surrounding oil development sites. We used a one-sample proportion test, comparing overall rates from the California Health Interview Survey (CHIS) of Service Planning Area 6 (SPA6) and Los Angeles County for variables of interest such as asthma. Field calibrated low-cost sensors recorded methane emissions. Physician diagnosed asthma rates were reported to be higher within both buffers than in SPA6 or LA County. Asthma prevalence in West Adams but not University Park was significantly higher than in Los Angeles County. Respondents with diagnosed asthma reported rates of emergency room visits in the previous 12 months similar to SPA6. 45% of respondents were unaware of oil development; 63% of residents would not know how to contact local regulatory authorities. Residents often seek information about their health and site-related activities. Low-cost sensors may be useful in highlighting differences between sites or recording larger emission events and can provide localized data alongside resident-reported symptoms. Regulatory officials should help clarify information to the community on methods for reporting health symptoms. Our community-based participatory research (CBPR) partnership supports efforts to answer community questions as residents seek a safety buffer between sensitive land uses and active oil development. PMID:29342985

Community-Based Health and Exposure Study around Urban Oil Developments in South Los Angeles.

PubMed

Shamasunder, Bhavna; Collier-Oxandale, Ashley; Blickley, Jessica; Sadd, James; Chan, Marissa; Navarro, Sandy; Hannigan, Michael; Wong, Nicole J

2018-01-15

Oilfield-adjacent communities often report symptoms such as headaches and/or asthma. Yet, little data exists on health experiences and exposures in urban environments with oil and gas development. In partnership with Promotoras de Salud (community health workers), we gathered household surveys nearby two oil production sites in Los Angeles. We tested the capacity of low-cost sensors for localized exposure estimates. Bilingual surveys of 205 randomly sampled residences were collected within two 1500 ft. buffer areas (West Adams and University Park) surrounding oil development sites. We used a one-sample proportion test, comparing overall rates from the California Health Interview Survey (CHIS) of Service Planning Area 6 (SPA6) and Los Angeles County for variables of interest such as asthma. Field calibrated low-cost sensors recorded methane emissions. Physician diagnosed asthma rates were reported to be higher within both buffers than in SPA6 or LA County. Asthma prevalence in West Adams but not University Park was significantly higher than in Los Angeles County. Respondents with diagnosed asthma reported rates of emergency room visits in the previous 12 months similar to SPA6. 45% of respondents were unaware of oil development; 63% of residents would not know how to contact local regulatory authorities. Residents often seek information about their health and site-related activities. Low-cost sensors may be useful in highlighting differences between sites or recording larger emission events and can provide localized data alongside resident-reported symptoms. Regulatory officials should help clarify information to the community on methods for reporting health symptoms. Our community-based participatory research (CBPR) partnership supports efforts to answer community questions as residents seek a safety buffer between sensitive land uses and active oil development.

Determinants of childhood immunisation coverage in urban poor settlements of Delhi, India: a cross-sectional study.

PubMed

Devasenapathy, Niveditha; Ghosh Jerath, Suparna; Sharma, Saket; Allen, Elizabeth; Shankar, Anuraj H; Zodpey, Sanjay

2016-08-26

Aggregate data on childhood immunisation from urban settings may not reflect the coverage among the urban poor. This study provides information on complete childhood immunisation coverage among the urban poor, and explores its household and neighbourhood-level determinants. Urban poor community in the Southeast district of Delhi, India. We randomly sampled 1849 children aged 1-3.5 years from 13 451 households in 39 clusters (cluster defined as area covered by a community health worker) in 2 large urban poor settlements. Of these, 1343 completed the survey. We collected information regarding childhood immunisation (BCG, oral polio vaccine, diphtheria-pertussis-tetanus vaccine, hepatitis B and measles) from vaccination cards or mothers' recall. We used random intercept logistic regression to explore the sociodemographic determinants of complete immunisation. Complete immunisation coverage was 46.7% and 7.5% were not immunised. The odds of complete vaccination (OR, 95% CI) were lower in female children (0.70 (0.55 to 0.89)) and Muslim households (0.65 (0.45 to 0.94)). The odds of complete vaccination were higher if the mother was literate (1.6 (1.15 to 2.16)), if the child was born within the city (2.7 (1.97 to 3.65)), in a health facility ( 1.5 (1.19 to 2.02)), belonged to the highest wealth quintile (compared with the poorest; 2.46 (1.5 to 4.02)) or possessed a birth certificate (1.40 (1.03 to 1.91)). Cluster effect due to unmeasured neighbourhood factors expressed as median OR was 1.32. Immunisation coverage in this urban poor area was much lower than that of regional surveys reporting overall urban data. Socioeconomic status of the household, female illiteracy, health awareness and gender inequality were important determinants of coverage in this population. Hence, in addition to enhancing the infrastructure for providing mother and child services, efforts are also needed to address these issues in order to improve immunisation coverage in deprived urban communities. CTRI/2011/091/000095. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Legacy, legitimacy, and possibility: an exploration of community health worker experience across the generations in Khayelitsha, South Africa.

PubMed

Swartz, Alison

2013-06-01

In South Africa, the response to HIV and TB epidemics is complex, varied, and contextually defined. "Task-shifting" and a movement toward a decentralized model of care have led to an increased reliance on community health workers (CHWs) providing health care services to residents of impoverished, peri-urban areas. Public health policy tends to present CHWs as a homogeneous group, with little attention paid to the nuances of experience, motivation, and understanding, which distinguish these care workers from one another and from other kinds of health workers. An exploration of the layered meanings of providing community health care services under financially, politically, and socially difficult conditions reveals clear distinctions of experience across the generations. Many older CHWs say that ubuntu, a notion of shared African humanity, is being "killed off" by the younger generation, whereas younger CHWs often describe older women as being "jealous" of the opportunities that this younger generation has for education, training, and employment. The structure of the South African health system, past and present responses to disease epidemics, and the legacy of apartheid's structural violence have amplified these generational differences among CHWs. Using ethnographic data collected from approximately 20 CHWS in a peri-urban settlement in Cape Town, South Africa, I explore how CHWs experience and understand legitimacy in the moral economy of care. A call for closer attention to the experiences of CHWs is critical when designing public health policies for the delivery of health care services in impoverished communities in South Africa. © 2013 by the American Anthropological Association.

A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties

ERIC Educational Resources Information Center

McKay, Mary M.; Gopalan, Geetha; Franco, Lydia; Dean-Assael, Kara; Chacko, Anil; Jackson, Jerrold M.; Fuss, Ashley

2011-01-01

This article presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within 13 urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this article focuses on parent…

Diagnostic Profiles among Urban Adolescents with Unmet Treatment Needs: Comorbidity and Perceived Need for Treatment

ERIC Educational Resources Information Center

Hogue, Aaron; Dauber, Sarah

2013-01-01

The goal of this study was to document comorbidity profiles of psychiatric disorder and perceived need for treatment among urban adolescents with unmet behavioral health needs. Participants were 303 community-referred adolescents and their primary caregivers. Adolescents included both boys (54%) and girls and were primarily Hispanic (58%), African…

The Impact of Adverse Childhood Experiences on an Urban Pediatric Population

ERIC Educational Resources Information Center

Burke, Nadine J.; Hellman, Julia L.; Scott, Brandon G.; Weems, Carl F.; Carrion, Victor G.

2011-01-01

Objective: The goal of this study was to investigate the adverse childhood experiences (ACEs) in youth in a low-income, urban community. Study design: Data from a retrospective chart review of 701 subjects from the Bayview Child Health Center in San Francisco are presented. Medical chart documentation of ACEs as defined in previous studies were…

Perceived School and Neighborhood Safety, Neighborhood Violence and Academic Achievement in Urban School Children

ERIC Educational Resources Information Center

Milam, A. J.; Furr-Holden, C. D. M.; Leaf, P. J.

2010-01-01

Community and school violence continue to be a major public health problem, especially among urban children and adolescents. Little research has focused on the effect of school safety and neighborhood violence on academic performance. This study examines the effect of the school and neighborhood climate on academic achievement among a population…

Indicators of Home Care Use in Urban and Rural Settings

ERIC Educational Resources Information Center

Mitchell, Lori A.; Strain, Laurel A.; Blandford, Audrey A.

2007-01-01

This study employs a longitudinal design to examine rural-urban differences in home care service use over time, drawing on data from the Manitoba Study of Health and Aging (MSHA). Characteristics of community-dwelling, cognitively intact adults aged 65 years or older not receiving home care services in the province of Manitoba (n = 855) were…

Urban-Rural Differences in the Availability of Hospital Information Technology Applications: A Survey of Georgia Hospitals

ERIC Educational Resources Information Center

Culler, Steven D.; Atherly, Adam; Walczak, Sandra; Davis, Anne; Hawley, Jonathan N.; Rask, Kimberly J.; Naylor, Vi; Thorpe, Kenneth E.

2006-01-01

Context: Information technology (IT) has been identified as a potential tool for improving the safety of health care delivery. Purpose: To determine if there are significant differences between urban and rural community hospitals in the availability of selected IT functional applications and technological devices. Methods: A mailed survey of…

Soil Lead Testing at a High Spatial Resolution in an Urban Community Garden: A Case Study in Relic Lead in Terre Haute, Indiana.

PubMed

Latimer, Jennifer C; Van Halen, David; Speer, James; Krull, Stephanie; Weaver, Patricia; Pettit, Joseph; Foxx, Heather

2016-10-01

Industrial emissions, deteriorating or improperly removed lead paint, and the use of lead additives in fuel have left a substantial burden of heavy metals, such as lead, in urban soils. Much of this lead remains near the surface where it has the potential to impact human health. Exposure to lead, especially in children, can have lasting impacts on neurological development and academic achievement. Urban gardening, in particular, is an activity that could result in increased exposure to soil lead for many unsuspecting gardeners. During the summer of 2012, more than 1,061 surface soil samples were collected from an approximately 1.25 acre urban community garden in Terre Haute, Indiana. Samples were collected to evaluate the spatial distribution of lead across the community garden on the plot level. The results highlight the variability that can be seen within small areas of a former residential property, for example lead concentrations that are low (<200 parts per million [ppm]) within the same 10 x 10 foot garden plot as concentrations that are considered high (>600 ppm). Based on the results of this work, several areas of concern were identified and the community garden was reconfigured to reduce potential lead exposure to gardeners and the local community.

Evaluating the Impact of Conflict Resolution on Urban Children's Violence-Related Attitudes and Behaviors in New Haven, Connecticut, through a Community-Academic Partnership

ERIC Educational Resources Information Center

Shuval, Kerem; Pillsbury, Charles A.; Cavanaugh, Brenda; McGruder, La'rie; McKinney, Christy M.; Massey, Zohar; Groce, Nora E.

2010-01-01

Numerous schools are implementing youth violence prevention interventions aimed at enhancing conflict resolution skills without evaluating their effectiveness. Consequently, we formed a community-academic partnership between a New Haven community-based organization and Yale's School of Public Health and Prevention Research Center to examine the…

The Impact of AIDS on the Black Community.

ERIC Educational Resources Information Center

Hatchett, David

1990-01-01

More than 25 percent of those who have the Acquired Immune Deficiency Syndrome (AIDS) virus are African American, and, in large urban areas, the disease is a leading cause of death, especially among black women. AIDS education is vital to supplement health care efforts in the black community. (SLD)

Health Behaviors of Culturally Diverse Inner-City Community College Students

ERIC Educational Resources Information Center

Heller, Janet R.; Sarmiento, Ariel L.

2016-01-01

Objective: To determine the prevalence of risk behaviors related to cigarette use, alcohol use, nutrition, physical fitness, and sexual behavior. Participants: Participants were 1,075 students attending an urban community college during the Spring 2012 semester. Methods: Data were collected in randomly selected classes using the American College…

Physical activity level and its sociodemographic correlates in a peri-urban Nepalese population: a cross-sectional study from the Jhaukhel-Duwakot health demographic surveillance site.

PubMed

Vaidya, Abhinav; Krettek, Alexandra

2014-03-14

Physical inactivity is a leading risk factor for cardiovascular and other noncommunicable diseases in high-, low- and middle-income countries. Nepal, a low-income country in South Asia, is undergoing an epidemiological transition. Although the reported national prevalence of physical inactivity is relatively low, studies in urban and peri-urban localities have always shown higher prevalence. Therefore, this study aimed to measure physical activity in three domains-work, travel and leisure-in a peri-urban community and assess its variations across different sociodemographic correlates. Adult participants (n=640) from six randomly selected wards of the Jhaukhel-Duwakot Health Demographic Surveillance Site (JD-HDSS) near Kathmandu responded to the Global Physical Activity Questionnaire. To determine total physical activity, we calculated the metabolic equivalent of task in minutes/week for each domain and combined the results. Respondents were categorized into high, moderate or low physical activity. We also calculated the odds ratio for low physical activity in various sociodemographic variables and self-reported cardiometabolic states. The urbanizing JD-HDSS community showed a high prevalence of low physical activity (43.3%; 95% CI 39.4-47.1). Work-related activity contributed most to total physical activity. Furthermore, women and housewives and older, more educated and self-or government-employed respondents showed a greater prevalence of physical inactivity. Respondents with hypertension, diabetes or overweight/obesity reported less physical activity than individuals without those conditions. Only 5% of respondents identified physical inactivity as a cardiovascular risk factor. Our findings reveal a high burden of physical inactivity in a peri-urban community of Nepal. Improving the level of physical activity involves sensitizing people to its importance through appropriate multi-sector strategies that provide encouragement across all sociodemographic groups.

Why have physical activity levels declined among Chinese adults? Findings from the 1991-2006 China Health and Nutrition Surveys.

PubMed

Ng, Shu Wen; Norton, Edward C; Popkin, Barry M

2009-04-01

Between 1991 and 2006, average weekly physical activity among adults in China fell by 32%. This paper discusses why total and occupational physical activity levels have fallen, and models the association between the rapid decline and various dimensions of exogenous community urbanization. We hypothesize that a) physical activity levels are negatively associated with urbanization; b) urbanization domains that affect job functions and opportunities will contribute most to changes in physical activity levels; and c) these urbanization domains will be more strongly associated for men than for women because home activities account for a larger proportion of physical activity for women. To test these hypotheses, we used longitudinal data from individuals aged 18-55 in the 1991-2006 China Health and Nutrition Surveys. We find that physical activity declines were strongly associated with greater availability of higher educational institutions, housing infrastructure, sanitation improvements and the economic wellbeing of the community in which people function. These urbanization factors predict more than four-fifths of the decline in occupational physical activity over the 1991-2006 period for men and nearly two-thirds of the decline for women. They are also associated with 57% of the decline in total physical activity for men and 40% of the decline for women. Intervention strategies to promote physical activity in the workplace, at home, for transit and via exercise should be considered a major health priority in China.

Why have physical activity levels declined among Chinese adults? Findings from the 1991 - 2006 China Health and Nutrition Surveys

PubMed Central

Ng, Shu Wen; Norton, Edward C; Popkin, Barry M

2009-01-01

Between 1991 and 2006, average weekly physical activity among adults in China fell by 32%. This paper discusses why total and occupational physical activity levels have fallen, and models the association between the rapid decline and various dimensions of exogenous community urbanization. We hypothesize that a) physical activity levels are negatively associated with urbanization; b) urbanization domains that affect job functions and opportunities will contribute most to changes in physical activity levels; and c) these urbanization domains will be more strongly associated for men than for women because home activities account for a larger proportion of physical activity for women. To test these hypotheses, we used longitudinal data from individuals aged 18 to 55 in the 1991-2006 China Health and Nutrition Surveys. We find that physical activity declines were strongly associated with greater availability of higher educational institutions, housing infrastructure, sanitation improvements and the economic well-being of the community in which people function. These urbanization factors predict more than four-fifths of the decline in occupational physical activity over the 1991-2006 period for men and nearly two-thirds of the decline for women. They are also associated with 57% of the decline in total physical activity for men and 40% of the decline for women. Intervention strategies to promote physical activity in the workplace, at home, for transit and via exercise should be considered a major health priority in China. PMID:19232811

Examining the Developmental Process of Risk for Exposure to Community Violence among Urban Youth

PubMed Central

Lambert, Sharon F.; Bradshaw, Catherine P.; Cammack, Nicole L.; Ialongo, Nicholas S.

2013-01-01

Considerable research has documented the effects of community violence exposure on adolescents’ behavior and mental health functioning, yet there has been less research on the process by which early risks increase the likelihood that youth will be exposed to community violence. The current study used data from a community epidemiologically-defined sample of 623 urban youth followed from first grade through adolescence to examine the process by which early-onset aggressive behavior and poor academic readiness influenced risk for community violence exposure. Consistent with transactional developmental theories, early-onset aggressive and disruptive behavior was associated with poor academic readiness; these early risks contributed to later peer rejection, and subsequent conduct problems and greater affiliation with deviant peers, which in turn increased youths’ exposure to community violence. Having an enhanced understanding of the risk process directs attention to potential targets for preventive interventions for youth at risk for subsequent exposure to violence. PMID:21480029

Promoting oral health among the inner city homeless: a community-academic partnership.

PubMed

Lashley, Mary

2008-09-01

Oral health care resources for the homeless are scarce, underfunded, and generally inadequate to meet the oral health needs of this population. The purpose of this program was to improve oral health among the urban homeless in a faith-based inner city mission through education, screening, and improved access to oral health care. The program provided for expanded delivery of oral health care services to the homeless while preparing students in the health professions for community-based practice with at-risk and vulnerable populations. By proactively addressing oral health needs through prevention and earlier diagnosis and treatment, morbidity, quality of life, and cost can be positively affected. Innovative, cross-disciplinary, community delivery models that involve key stakeholders at all levels are needed to address the oral health needs of the homeless and underserved adequately.

Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study.

PubMed

Lorent, Natalie; Choun, Kimcheng; Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

2015-01-01

While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in marginalised communities.

Challenges from Tuberculosis Diagnosis to Care in Community-Based Active Case Finding among the Urban Poor in Cambodia: A Mixed-Methods Study

PubMed Central

Malhotra, Shelly; Koeut, Pichenda; Thai, Sopheak; Khun, Kim Eam; Colebunders, Robert; Lynen, Lut

2015-01-01

Background While community-based active case finding (ACF) for tuberculosis (TB) holds promise for increasing early case detection among hard-to-reach populations, limited data exist on the acceptability of active screening. We aimed to identify barriers and explore facilitators on the pathway from diagnosis to care among TB patients and health providers. Methods Mixed-methods study. We administered a survey questionnaire to, and performed in-depth interviews with, TB patients identified through ACF from poor urban settlements in Phnom Penh, Cambodia. Additionally, we conducted focus group discussions and in-depth interviews with community and public health providers involved in ACF, respectively. Results Acceptance of home TB screening was strong among key stakeholders due to perceived reductions in access barriers and in direct and indirect patient costs. Privacy and stigma were not an issue. To build trust and facilitate communication, the participation of community representatives alongside health workers was preferred. Most health providers saw ACF as complementary to existing TB services; however, additional workload as a result of ACF was perceived as straining operating capacity at public sector sites. Proximity to a health facility and disease severity were the strongest determinants of prompt care-seeking. The main reasons reported for delays in treatment-seeking were non-acceptance of diagnosis, high indirect costs related to lost income/productivity and transportation expenses, and anticipated side-effects from TB drugs. Conclusions TB patients and health providers considered home-based ACF complementary to facility-based TB screening. Strong engagement with community representatives was believed critical in gaining access to high risk communities. The main barriers to prompt treatment uptake in ACF were refusal of diagnosis, high indirect costs, and anticipated treatment side-effects. A patient-centred approach and community involvement were essential in mitigating barriers to care in marginalised communities. PMID:26222545

Integrating public health and community development to tackle neighborhood distress and promote well-being.

PubMed

Pastor, Manuel; Morello-Frosch, Rachel

2014-11-01

Recently there have been calls for public health to reconnect to urban planning in ways that emphasize the impact of place on health and that address fundamental causes of poor health, such as poverty, social inequality, and discrimination. Community developers have realized that poor health limits individuals' and communities' economic potential and have begun to integrate into their work such neighborhood health issues as access to fresh food and open space. In this article we review recent shifts in the community development field and give examples of programs that operate at the intersection of community development, public health, and civic engagement. For example, in Sacramento, California, the Building Healthy Communities program successfully promoted the creation of community gardens and bike paths and the redevelopment of brownfields. A major housing revitalization initiative in San Francisco, California, known as Sunnydale-Velasco, is transforming the city's largest public housing site into a mixed-income community that provides existing residents with new housing, infrastructure, services, and amenities. These examples and others illustrate the need to identify and make use of interdisciplinary approaches to ensure that all places are strong platforms for economic mobility, full democratic participation, and community health. Project HOPE—The People-to-People Health Foundation, Inc.

Child overweight and undernutrition in Thailand: is there an urban effect?

PubMed

Firestone, Rebecca; Punpuing, Sureeporn; Peterson, Karen E; Acevedo-Garcia, Dolores; Gortmaker, Steven L

2011-05-01

An urban advantage in terms of lower risk of child undernutrition has been observed in many developing countries, but child obesity is often more prevalent in urban than rural areas. This study aimed to assess whether urban-rural disparities in undernutrition and obesity were attributable to concentrations of socioeconomically advantaged children into urban communities or to specific aspects of the urban environment. A sample of 4610 children ages 2-10 years was derived from the 2004 Round of the Kanchanaburi Demographic Surveillance System, monitoring health and demographic change in the province of Kanchanaburi, Thailand. We used multi-level logistic regression to model the odds of short stature, underweight, and obesity for children in 102 communities. Models tested whether child socioeconomic conditions accounted for urban-rural disparities or if aspects of the social and physical environment accounted for disparities, adjusting for child characteristics. 27.8% of children were underweight, while 19.9% had short stature, and 8.3% were obese. Bivariate associations showed urban residence associated with lower risk of undernutrition and a greater risk of obesity. Urban-rural disparities in odds of short stature and underweight were accounted for by child socioeconomic characteristics. Urban residence persisted as a risk factor for obesity after adjusting for child characteristics. Community wealth concentration, television coverage, and sanitation coverage were independently associated with greater risk of obesity. Undernutrition was strongly associated with household poverty, while household affluence and characteristics of the urban environment were associated with odds of obesity. Further research is needed to characterize how urban environments contribute to children's risks of obesity in developing countries. Copyright © 2011 Elsevier Ltd. All rights reserved.

Urbanicity and lifestyle risk factors for cardiometabolic diseases in rural Uganda: a cross-sectional study.

PubMed

Riha, Johanna; Karabarinde, Alex; Ssenyomo, Gerald; Allender, Steven; Asiki, Gershim; Kamali, Anatoli; Young, Elizabeth H; Sandhu, Manjinder S; Seeley, Janet

2014-07-01

Urban living is associated with unhealthy lifestyles that can increase the risk of cardiometabolic diseases. In sub-Saharan Africa (SSA), where the majority of people live in rural areas, it is still unclear if there is a corresponding increase in unhealthy lifestyles as rural areas adopt urban characteristics. This study examines the distribution of urban characteristics across rural communities in Uganda and their associations with lifestyle risk factors for chronic diseases. Using data collected in 2011, we examined cross-sectional associations between urbanicity and lifestyle risk factors in rural communities in Uganda, with 7,340 participants aged 13 y and above across 25 villages. Urbanicity was defined according to a multi-component scale, and Poisson regression models were used to examine associations between urbanicity and lifestyle risk factors by quartile of urbanicity. Despite all of the villages not having paved roads and running water, there was marked variation in levels of urbanicity across the villages, largely attributable to differences in economic activity, civil infrastructure, and availability of educational and healthcare services. In regression models, after adjustment for clustering and potential confounders including socioeconomic status, increasing urbanicity was associated with an increase in lifestyle risk factors such as physical inactivity (risk ratio [RR]: 1.19; 95% CI: 1.14, 1.24), low fruit and vegetable consumption (RR: 1.17; 95% CI: 1.10, 1.23), and high body mass index (RR: 1.48; 95% CI: 1.24, 1.77). This study indicates that even across rural communities in SSA, increasing urbanicity is associated with a higher prevalence of lifestyle risk factors for cardiometabolic diseases. This finding highlights the need to consider the health impact of urbanization in rural areas across SSA. Please see later in the article for the Editors' Summary.

[Assessment on the short-term impact regarding the community-based interventions to improve physical activities in three urban areas of Hangzhou city].

PubMed

Gao, Fang; Liu, Qing-min; Ren, Yan-jun; He, Ping-ping; LV, Jun; Li, Li-ming

2013-06-01

To evaluate the short-term impact of comprehensive community based intervention on physical activity (PA) of adults living in the three urban communities of Hangzhou city. Within the framework of Community Interventions for Health (CIH) Program, a community trial was conducted in two urban areas (Xiacheng district and Gongshu district)and an urban area(Xihu district)as control, by a parallel comparison and random grouping based quasi-experimental design. Two independent questionnaire-based surveys of cross-sectional samples in the intervention and comparison areas were used to assess the short-term impact of the intervention program. A total of 2016 adults at baseline and 2016 adults at follow-up stages, completed the survey, including 1016 adults from the intervention areas and 1000 from the comparison area. Over the two-year intervention period, the cognitive level on benefits of physical activity in the intervention areas were trending downward. The changes observed in the comparison area did not show statistical significance. Intervention areas showed a statistically significant increase (1204 vs. 1386, P = 0.023) in the level of physical activity(metabolic equivalent, MET-minutes/week)compared with the comparison area(918 vs. 924, P = 0.201). And results remained the same after eliminating the possible effects of age factor. After a two-year intervention, beneficial changes were noted in the intervention areas with respect to the level of physical activity. A community-based intervention program on physical activity seemed feasible and effective in the urban areas of Hangzhou.

The size, characteristics and partnership networks of the health-related non-profit sector in three regions of South Africa: implications of changing primary health care policy for community-based care.

PubMed

van Pletzen, Ermien; Zulliger, R; Moshabela, M; Schneider, H

2014-09-01

Health-related community-based care in South Africa is mostly provided through non-profit organizations (NPOs), but little is known about the sector. In the light of emerging government policy on greater formalization of community-based care in South Africa, this article assesses the size, characteristics and partnership networks of health-related NPOs in three South African communities and explores implications of changing primary health care policy for this sector. Data were collected (2009-11) from three sites: Khayelitsha (urban), Botshabelo (semi-rural) and Bushbuckridge (semi/deep rural). Separate data sources were used to identify all health-related NPOs in the sites. Key characteristics of identified NPOs were gathered using a standardized tool. A typology of NPOs was developed combining level of resources (well, moderate, poor) and orientation of activities ('Direct service', 'Developmental' and/or 'Activist'). Network analysis was performed to establish degree and density of partnerships among NPOs. The 138 NPOs (n = 56 in Khayelitsha, n = 47 in Bushbuckridge; n = 35 in Botshabelo) were mostly local community-based organizations (CBOs). The main NPO orientation was 'Direct service' (n = 120, 87%). Well- and moderately resourced NPOs were successful at combining orientations. Most organizations with an 'Activist' orientation were urban. No poorly resourced organizations had this orientation. Well-resourced organizations with an 'Activist' orientation were highly connected in Khayelitsha NPO networks, while poorly resourced CBOs were marginalized. A contrasting picture emerged in Botshabelo where CBOs were highly connected. Networks in Bushbuckridge were fragmented and linear. The NPO sector varies geographically in numbers, resources, orientation of activities and partnership networks. NPOs may perform important developmental roles and strong potential for social capital may reside in organizational networks operating in otherwise impoverished environments. A uniform approach to policy implementation may not accommodate variations in the NPO sector. Considerations for adaptation may be necessary in light of the observed differences between urban and rural settings. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

Reaching for Health Equity and Social Justice in Baltimore: The Evolution of an Academic-Community Partnership and Conceptual Framework to Address Hypertension Disparities

PubMed Central

Cooper, Lisa A.; Purnell, Tanjala S.; Ibe, Chidinma A.; Halbert, Jennifer P.; Bone, Lee R.; Carson, Kathryn A.; Hickman, Debra; Simmons, Michelle; Vachon, Ann; Robb, Inez; Martin-Daniels, Michelle; Dietz, Katherine B.; Golden, Sherita Hill; Crews, Deidra C.; Hill-Briggs, Felicia; Marsteller, Jill A.; Boulware, L. Ebony; Miller, Edgar R. III; Levine, David M.

2016-01-01

Cardiovascular health disparities persist despite decades of recognition and the availability of evidence-based clinical and public health interventions. Racial and ethnic minorities and adults in urban and low-income communities are high-risk groups for uncontrolled hypertension (HTN), a major contributor to cardiovascular health disparities, in part due to inequitable social structures and economic systems that negatively impact daily environments and risk behaviors. This commentary presents the Johns Hopkins Center to Eliminate Cardiovascular Health Disparities as a case study for highlighting the evolution of an academic-community partnership to overcome HTN disparities. Key elements of the iterative development process of a Community Advisory Board (CAB) are summarized, and major CAB activities and engagement with the Baltimore community are highlighted. Using a conceptual framework adapted from O’Mara-Eves and colleagues, the authors discuss how different population groups and needs, motivations, types and intensity of community participation, contextual factors, and actions have shaped the Center’s approach to stakeholder engagement in research and community outreach efforts to achieve health equity. PMID:27440977

Modeling Social Dimensions of Oral Health among Older Adults in Urban Environments

ERIC Educational Resources Information Center

Metcalf, Sara S.; Northridge, Mary E.; Widener, Michael J.; Chakraborty, Bibhas; Marshall, Stephen E.; Lamster, Ira B.

2013-01-01

In both developed and developing countries, population aging has attained unprecedented levels. Public health strategies to deliver services in community-based settings are key to enhancing the utilization of preventive care and reducing costs for this segment of the population. Motivated by concerns of inadequate access to oral health care by…

What are the factors associated with good mental health among Aboriginal children in urban New South Wales, Australia? Phase I findings from the Study of Environment on Aboriginal Resilience and Child Health (SEARCH).

PubMed

Williamson, Anna; D'Este, Catherine; Clapham, Kathleen; Redman, Sally; Manton, Toni; Eades, Sandra; Schuster, Leanne; Raphael, Beverley

2016-07-05

To identify the factors associated with 'good' mental health among Aboriginal children living in urban communities in New South Wales, Australia. Cross-sectional survey (phase I of a longitudinal study). 4 Aboriginal Community Controlled Health Services that deliver primary care. All services were located in urban communities in New South Wales, Australia. 1005 Aboriginal children aged 4-17 years who participated in phase I of the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Carer report version of the Strengths and Difficulties Questionnaire. Scores <17 were considered to indicate 'good' mental health for the purposes of this article. The majority (72%) of SEARCH participants were not at high risk for emotional or behavioural problems. After adjusting for the relative contributions of significant demographic, child and carer health factors, the factors associated with good mental health among SEARCH children were having a carer who was not highly psychologically distressed (OR=2.8, 95% CI 1.6 to 5.1); not suffering from frequent chest, gastrointestinal or skin infections (OR=2.8, 95% CI 1.8 to 4.3); and eating two or more servings of vegetables per day (OR=2.1, 95% CI 1.2 to 3.8). Being raised by a foster carer (OR=0.2, 95% CI 0.01 to 0.71) and having lived in 4 or more homes since birth (OR=0.62, 95% CI 0.39 to 1.0) were associated with significantly lower odds of good mental health. Slightly different patterns of results were noted for adolescents than younger children. Most children who participated in SEARCH were not at high risk for emotional or behavioural problems. Promising targets for efforts to promote mental health among urban Aboriginal children may include the timely provision of medical care for children and provision of additional support for parents and carers experiencing mental or physical health problems, for adolescent boys and for young people in the foster care system. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Immunization, urbanization and slums - a systematic review of factors and interventions.

PubMed

Crocker-Buque, Tim; Mindra, Godwin; Duncan, Richard; Mounier-Jack, Sandra

2017-06-08

In 2014, over half (54%) of the world's population lived in urban areas and this proportion will increase to 66% by 2050. This urbanizing trend has been accompanied by an increasing number of people living in urban poor communities and slums. Lower immunization coverage is found in poorer urban dwellers in many contexts. This study aims to identify factors associated with immunization coverage in poor urban areas and slums, and to identify interventions to improve coverage. We conducted a systematic review, searching Medline, Embase, Global Health, CINAHL, Web of Science and The Cochrane Database with broad search terms for studies published between 2000 and 2016. Of 4872 unique articles, 327 abstracts were screened, leading to 63 included studies: 44 considering factors and 20 evaluating interventions (one in both categories) in 16 low or middle-income countries. A wide range of socio-economic characteristics were associated with coverage in different contexts. Recent rural-urban migration had a universally negative effect. Parents commonly reported lack of awareness of immunization importance and difficulty accessing services as reasons for under-immunization of their children. Physical distance to clinics and aspects of service quality also impacted uptake. We found evidence of effectiveness for interventions involving multiple components, especially if they have been designed with community involvement. Outreach programmes were effective where physical distance was identified as a barrier. Some evidence was found for the effective use of SMS (text) messaging services, community-based education programmes and financial incentives, which warrant further evaluation. No interventions were identified that provided services to migrants from rural areas. Different factors affect immunization coverage in different urban poor and slum contexts. Immunization services should be designed in collaboration with slum-dwelling communities, considering the local context. Interventions should be designed and tested to increase immunization in migrants from rural areas.

Concussion Knowledge and Reporting Behavior Differences Between High School Athletes at Urban and Suburban High Schools.

PubMed

Wallace, Jessica; Covassin, Tracey; Nogle, Sally; Gould, Daniel; Kovan, Jeffrey

2017-09-01

We determined differences in knowledge of concussion and reporting behaviors of high school athletes attending urban and suburban high schools, and whether a relationship exists between underreporting and access to an athletic trainer in urban schools. High school athletes (N = 715) from 14 high schools completed a validated knowledge of concussion survey consisting of 83 questions. The independent variable was school type (urban/suburban). We examined the proportion of athletes who correctly identified signs and symptoms of concussion, knowledge of concussion and reasons why high school athletes would not disclose a potential concussive injury across school classification. Data were analyzed using descriptive, non-parametric, and inferential statistics. Athletes attending urban schools have less concussion knowledge than athletes attending suburban schools (p < .01). Athletes attending urban schools without an athletic trainer have less knowledge than urban athletes at schools with an athletic trainer (p < .01) There was no significant relationship between reporting percentage and school type (p = .73); however, significant relationships exist between AT access at urban schools and 10 reasons for not reporting. Concussion education efforts cannot be homogeneous in all communities. Education interventions must reflect the needs of each community. © 2017, American School Health Association.

Ensuring Access to Quality Health Care in Vulnerable Communities.

PubMed

Bhatt, Jay; Bathija, Priya

2018-04-24

For millions of Americans living in vulnerable rural and urban communities, their hospital is an important, and often their only, source of health care. As transformation in the hospital and health care field continues, some communities may be at risk of losing access to health care services and the opportunities and resources they need to improve and maintain their health. Integrated, comprehensive strategies to reform health care delivery and payment, within which vulnerable communities can make individual choices based on their needs, support structures, and preferences, are needed.In this Invited Commentary, the authors outline characteristics and parameters of vulnerable communities as well as the essential health care services that hospitals should strive to maintain locally identified by the American Hospital Association Task Force on Ensuring Access in Vulnerable Communities. They also describe four of nine emerging strategies-recommended by the task force-to reform health care delivery and payment and allow hospitals to provide the essential health care services, along with implementation barriers and how to address them. While this Invited Commentary focuses on vulnerable communities, the four highlighted strategies (addressing the social determinants of health, adopting new and innovative virtual care strategies, designing global budgets, and using inpatient/outpatient transformation strategy), as well as the other five strategies, may have broader applicability for all communities.

Continental-scale distributions of dust-associated bacteria and fungi

PubMed Central

Barberán, Albert; Ladau, Joshua; Pollard, Katherine S.; Menninger, Holly L.; Dunn, Robert R.; Fierer, Noah

2015-01-01

It has been known for centuries that microorganisms are ubiquitous in the atmosphere, where they are capable of long-distance dispersal. Likewise, it is well-established that these airborne bacteria and fungi can have myriad effects on human health, as well as the health of plants and livestock. However, we have a limited understanding of how these airborne communities vary across different geographic regions or the factors that structure the geographic patterns of near-surface microbes across large spatial scales. We collected dust samples from the external surfaces of ∼1,200 households located across the United States to understand the continental-scale distributions of bacteria and fungi in the near-surface atmosphere. The microbial communities were highly variable in composition across the United States, but the geographic patterns could be explained by climatic and soil variables, with coastal regions of the United States sharing similar airborne microbial communities. Although people living in more urbanized areas were not found to be exposed to distinct outdoor air microbial communities compared with those living in more rural areas, our results do suggest that urbanization leads to homogenization of the airborne microbiota, with more urban communities exhibiting less continental-scale geographic variability than more rural areas. These results provide our first insight into the continental-scale distributions of airborne microbes, which is information that could be used to identify likely associations between microbial exposures in outdoor air and incidences of disease in crops, livestock, and humans. PMID:25902536

From Worker Health To Citizen Health: Moving Upstream

PubMed Central

Sepulveda, Martin-Jose

2014-01-01

New rapid growth economies, urbanization, health systems crises and “big data” are causing fundamental changes in social structures and systems including health. These forces for change have significant consequences for occupational and environmental medicine and will challenge the specialty to think beyond workers and workplaces as the principal locus of innovation for health and performance. These trends are placing great emphasis on upstream strategies for addressing the complex systems dynamics of the social determinants of health. The need to engage systems in communities for healthier workforces is a shift in orientation from worker and workplace centric to citizen and community centric. This change for occupational and environmental medicine requires extending systems approaches in the workplace to communities which are systems of systems and which require different skills, data, tools and partnerships. PMID:24284749

From worker health to citizen health: moving upstream.

PubMed

Sepulveda, Martin-Jose

2013-12-01

New rapid growth economies, urbanization, health systems crises, and "big data" are causing fundamental changes in social structures and systems, including health. These forces for change have significant consequences for occupational and environmental medicine and will challenge the specialty to think beyond workers and workplaces as the principal locus of innovation for health and performance. These trends are placing great emphasis on upstream strategies for addressing the complex systems dynamics of the social determinants of health. The need to engage systems in communities for healthier workforces is a shift in orientation from worker and workplace centric to citizen and community centric. This change for occupational and environmental medicine requires extending systems approaches in the workplace to communities that are systems of systems and that require different skills, data, tools, and partnerships.

Localized Health News Releases and Community Newspapers: A Method for Rural Health Promotion.

PubMed

Young, Rachel; Willis, Erin; Stemmle, John; Rodgers, Shelly

2015-07-01

Newspaper health stories often originate with news releases from health organizations. Tailoring news releases to a particular mass media outlet increases the possibility that the release will result in a published story. This study describes a 2-year effort to promote coverage of health through dissemination of localized health news releases to newspapers. Each newspaper received stories tailored to that community. Localized elements of stories included local headlines and local data. Nearly half of newspapers in our study (48.2%) published at least one of our health news stories, and 541 health news stories were published as a result of the project. We also examined which types of newspapers were most likely to publish health news stories. Newspapers in rural versus suburban and urban areas were more likely to publish health news stories, as were midsized newspapers. In addition, rural newspapers were more likely than urban newspapers to publish stories about aging, specifically arthritis and heart disease. Our findings indicate that tailoring health news releases with local information and targeting releases to align with newspaper audience demographics could increase the quantity and quality of health-promoting information available to rural residents, who experience disparities in health care access and health outcomes. © 2015 Society for Public Health Education.

The astonishingly holistic role of urban soil in the exposure of children to lead.

NASA Astrophysics Data System (ADS)

Mielke, Howard; Gonzales, Christopher; Powell, Eric

2017-04-01

The long-term resilience and sustainability of urban communities is associated with its environmental quality. One major impediment to community welfare is children's exposure to lead because it is a root cause of disparity and chronic conditions including health, learning, and behavioral differences. There is no safe level of lead exposure and this revelation is confounded by the lack of an effective intervention after exposure takes place. In August, 2005, Hurricane Katrina flooded 80% of New Orleans. This report explores the natural experiment of the dynamic changes of soil and children's blood lead in New Orleans before and ten years after the flood. Matched pre- and post-Hurricane soil lead and children's blood lead results were stratified by 172 communities of New Orleans. GIS methods were used to organize, describe, and map the pre- and post-Katrina data. Comparing pre- and post-Katrina results, simultaneous decreases occurred in soil lead and children's blood lead response. Health and welfare disparities continue to exist between environments and children's exposure living in interior compared with outer communities of the city. At the scale of a city this investigation demonstrates that declining soil lead effectively reduces children's blood lead. The astonishingly holistic role of soil relates to its position as a lead dust deposition reservoir and, at the same time, as an open source of ingestible and inhalable lead dust. Decreasing the soil lead on play areas of urban communities is beneficial and economical as a method for effective lead intervention and primary prevention. References Mielke, H.W.; Gonzales, C.R.; Powell, E.T.; Mielke, P.W. Jr. Spatiotemporal dynamic transformations of soil lead and children's blood lead ten years after Hurricane Katrina: New grounds for primary prevention. Environ. Int. 2016, DOI: 10.1016/j.envint.2016.06.017. Mielke, H.W.; Gonzales, C.R.; Powell, E.T. In review. The dynamic lead exposome and children's health in New Orleans pre-and post-Hurricane Katrina. Int. J. Environ. Res. Public Health

Retention of female volunteer community health workers in Dhaka urban slums: a prospective cohort study

PubMed Central

2014-01-01

Background Volunteer community health workers (CHWs) are a key approach to improving community-based maternal and child health services in developing countries. BRAC, a large Bangladeshi non-governmental organization (NGO), has employed female volunteer CHWs in its community-based health programs since 1977, recently including its Manoshi project, a community-based maternal and child health intervention in the urban slums of Bangladesh. A case–control study conducted in response to high dropout rates in the first year of the project showed that financial incentives, social prestige, community approval and household responsibilities were related to early retention in the project. In our present prospective cohort study, we aimed to better understand the factors associated with retention of volunteer CHWs once the project was more mature. Methods We used a prospective cohort study design to examine the factors affecting retention of volunteer CHWs who remained in the project after the initial start-up period. We surveyed a random sample of 542 CHWs who were working for BRAC Manoshi in December 2008. In December 2009, we revisited this cohort of CHWs and interviewed those who had dropped out about the main reasons for their dropping out. We used a multivariable generalized linear model regression analysis with a log link to estimate the relative risk (RR) of independent factors on retention. Results Of the 542 CHWs originally enrolled, 120 had dropped out by the end of one year, mainly because they left the slums. CHWs who received positive community appraisal (adjusted RR = 1.45, 95% confidence interval (CI) = 1.10 to 1.91) or were associated with other NGOs (adjusted RR = 1.13, 95% CI = 1.04 to 1.23) were more likely to have been retained in the project. Although refresher training was also associated with increased retention (adjusted RR = 2.25, 95% CI = 1.08 to 4.71) in this study, too few CHWs had not attended refresher training regularly to make it a meaningful predictor of retention that could be applied in the project setting. Conclusion Factors that affect retention of CHWs may change over time, with some factors that are important in the early years of a project losing importance as the project matures. Community health programs operating in fragile urban slums should consider changing factors over program duration for better retention of volunteer CHWs. PMID:24886046

Overweight and obesity among low-income women in rural West Virginia and urban Los Angeles County.

PubMed

Robles, Brenda; Frost, Stephanie; Moore, Lucas; Harris, Carole V; Bradlyn, Andrew S; Kuo, Tony

2014-10-01

We described the prevalence of overweight and obesity among low-income women in rural West Virginia (WV) and urban Los Angeles County (LA County). Both communities participated in the national Communities Putting Prevention to Work program during 2010-2012. In each community, we completed health assessments on adult women recruited from public-sector clinics serving low-income populations. All participants answered survey questions regarding socio-demographics and diets. In both jurisdictions, we assessed obesity using objectively measured height and weight (calculated BMI). As part of each community case study, we performed multivariable regression analyses to describe the relationships between overweight and obesity and selected covariates (e.g., dietary behaviors). Overweight and obesity were prevalent among low-income women from WV (73%, combined) and LA County (67%, combined). In both communities, race and ethnicity appeared to predict the two conditions; however, the associations were not robust. In LA County, for example, African American and Hispanic women were 1.4 times (95% CI=1.12, 1.81) more likely than white women to be overweight and obese. Collectively, these subpopulation health data served as an important guide for further planning of obesity prevention efforts in both communities. These efforts became a part of the subsequent Community Transformation Grants portfolio. Copyright © 2014 Elsevier Inc. All rights reserved.

Addressing Urban Health in Detroit, New York City, and Seattle Through Community-Based Participatory Research Partnerships

PubMed Central

Metzler, Marilyn M.; Higgins, Donna L.; Beeker, Carolyn G.; Freudenberg, Nicholas; Lantz, Paula M.; Senturia, Kirsten D.; Eisinger, Alison A.; Viruell-Fuentes, Edna A.; Gheisar, Bookda; Palermo, Ann-Gel; Softley, Donald

2003-01-01

Objective. This study describes key activities integral to the development of 3 community-based participatory research (CBPR) partnerships. Methods. We compared findings from individual case studies conducted at 3 urban research centers (URCs) to identify crosscutting adaptations of a CBPR approach in the first 4 years of the partnerships’ development. Results. Activities critical in partnership development include sharing decisionmaking, defining principles of collaboration, establishing research priorities, and securing funding. Intermediate outcomes were sustained CBPR partnerships, trust within the partnerships, public health research programs, and increased capacity to conduct CBPR. Challenges included the time needed for meaningful collaboration, concerns regarding sustainable funding, and issues related to institutional racism. Conclusions. The URC experiences suggest that CBPR can be successfully implemented in diverse settings. PMID:12721148

Impact of nutrition education on health of the mother and newborn belonging to the poor urban slum community.

PubMed

Sur, D; Mukhopadhyay, S P; Biswas, R

1997-07-01

To find the nutritional knowledge among mothers of one child of the poor community and to relate status of education to the nutritional health of them and the newborn and to get a thorough knowledge on the impact of nutritional education, a comprehensive study was undertaken in an urban slum area. Nutritional grading was done through scoring system. There were 47 mothers (24.1%) out of 195 having normal nutritional grade and 37 mothers (19%) having severe nutritional grade. There were 80 mothers having 'no knowledge' on maternal nutrition. 'Adequate knowledge' was found in 31 cases. Mothers (n = 80) of 'no knowledge' delivered babies of average weight 2.3 kg whereas 'adequate knowledge' mothers gave birth to babies of average weight 2.9 kg.

HIV testing in community pharmacies and retail clinics: a model to expand access to screening for HIV infection.

PubMed

Weidle, Paul J; Lecher, Shirley; Botts, Linda W; Jones, LaDawna; Spach, David H; Alvarez, Jorge; Jones, Rhondette; Thomas, Vasavi

2014-01-01

To test the feasibility of offering rapid point-of-care human immunodeficiency virus (HIV) testing at community pharmacies and retail clinics. Pilot program to determine how to implement confidential HIV testing services in community pharmacies and retail clinics. 21 community pharmacies and retail clinics serving urban and rural patients in the United States, from August 2011 to July 2013. 106 community pharmacy and retail clinic staff members. A model was developed to implement confidential HIV counseling and testing services using community pharmacy and retail clinic staff as certified testing providers, or through collaborations with organizations that provide HIV testing. Training materials were developed and sites selected that serve patients from urban and rural areas to pilot test the model. Each site established a relationship with its local health department for HIV testing policies, developed referral lists for confirmatory HIV testing/care, secured a CLIA Certificate of Waiver, and advertised the service. Staff were trained to perform a rapid point-of-care HIV test on oral fluid, and provide patients with confidential test results and information on HIV. Patients with a preliminary positive result were referred to a physician or health department for confirmatory testing and, if needed, HIV clinical care. Number of HIV tests completed and amount of time required to conduct testing. The 21 participating sites administered 1,540 HIV tests, with 1,087 conducted onsite by staff during regular working hours and 453 conducted at 37 different HIV testing events (e.g., local health fairs). The median amount of time required for pretest counseling/consent, waiting for test results, and posttest counseling was 4, 23, and 3 minutes, respectively. A majority of the sites (17) said they planned to continue HIV testing after the project period ended and would seek assistance or support from the local health department, a community-based organization, or an AIDS service organization. This pilot project established HIV testing in several community pharmacies and retail clinics to be a feasible model for offering rapid, point-of-care HIV testing. It also demonstrated the willingness and ability of staff at community pharmacies and retail clinics to provide confidential HIV testing to patients. Expanding this model to additional sites and evaluating its feasibility and effectiveness may serve unmet needs in urban and rural settings.

Urban legacies and soil management affect the concentration and speciation of trace metals in Los Angeles community garden soils.

PubMed

Clarke, Lorraine Weller; Jenerette, G Darrel; Bain, Daniel J

2015-02-01

Heavy metals in urban soils can compromise human health, especially in urban gardens, where gardeners may ingest contaminated dust or crops. To identify patterns of urban garden metal contamination, we measured concentrations and bioavailability of Pb, As, and Cd in soils associated with twelve community gardens in Los Angeles County, CA. This included sequential extractions to partition metals among exchangeable, reducible, organic, or residual fractions. Proximity to road increased all metal concentrations, suggesting vehicle emissions sources. Reducible Pb increased with neighborhood age, suggesting leaded paint as a likely pollutant source. Exchangeable Cd and As both increased with road proximity. Only cultivated soils showed an increase in exchangeable As with road proximity, potentially due to reducing humic acid interactions while Cd bioavailability was mitigated by organic matter. Understanding the geochemical phases and metal bioavailability allows incorporation of contamination patterns into urban planning. Copyright © 2014 Elsevier Ltd. All rights reserved.

Meter-Scale Urban Land Cover in EPA EnviroAtlas: Data, Methods and Applications for Assessing Ecosystem Services in Urban Landscapes

NASA Astrophysics Data System (ADS)

Pilant, A. N.; Endres, K.; Pardo, S.; Khopkar, A.; Rosenbaum, D.; Fizer, C.; Panlasigui, S.; Neale, A. C.

2016-12-01

US EPA EnviroAtlas provides interactive tools and resources for exploring the benefits people receive from nature or "ecosystem goods and services". Ecosystem goods and services are critically important to human health and well-being, but they are often overlooked due to lack of information. Using EnviroAtlas, many types of users can access, view, and analyze diverse information to better understand the potential impacts of various decisions. EnviroAtlas data is available at two spatial scales: national and community. To enable meaningful analysis at the community-scale EPA has developed meter-scale urban land cover (MULC). data This high-resolution foundational data permit fine-grained analysis of ecosystem services in heterogeneous urban landscapes. Here we present the data and methods used to develop the MULC, and comment on best practices and lessons learned. We also present ecosystem service use cases that feature MULC data, including stream and road vegetative buffers, tree planting, and urban heat island reduction due to vegetation.

A rapid assessment scorecard to identify informal settlements at higher maternal and child health risk in Mumbai.

PubMed

Osrin, David; Das, Sushmita; Bapat, Ujwala; Alcock, Glyn A; Joshi, Wasundhara; More, Neena Shah

2011-10-01

The communities who live in urban informal settlements are diverse, as are their environmental conditions. Characteristics include inadequate access to safe water and sanitation, poor quality of housing, overcrowding, and insecure residential status. Interventions to improve health should be equity-driven and target those at higher risk, but it is not clear how to prioritise informal settlements for health action. In implementing a maternal and child health programme in Mumbai, India, we had conducted a detailed vulnerability assessment which, though important, was time-consuming and may have included collection of redundant information. Subsequent data collection allowed us to examine three issues: whether community environmental characteristics were associated with maternal and newborn healthcare and outcomes; whether it was possible to develop a triage scorecard to rank the health vulnerability of informal settlements based on a few rapidly observable characteristics; and whether the scorecard might be useful for future prioritisation. The City Initiative for Newborn Health documented births in 48 urban slum areas over 2 years. Information was collected on maternal and newborn care and mortality, and also on household and community environment. We selected three outcomes-less than three antenatal care visits, home delivery, and neonatal mortality-and used logistic regression and classification and regression tree analysis to test their association with rapidly observable environmental characteristics. We developed a simple triage scorecard and tested its utility as a means of assessing maternal and newborn health risk. In analyses on a sample of 10,754 births, we found associations of health vulnerability with inadequate access to water, toilets, and electricity; non-durable housing; hazardous location; and rental tenancy. A simple scorecard based on these had limited sensitivity and positive predictive value, but relatively high specificity and negative predictive value. The scorecard needs further testing in a range of urban contexts, but we intend to use it to identify informal settlements in particular need of family health interventions in a subsequent program.

The impact of realignment on utilization and cost of community-based mental health services in California.

PubMed

Scheffler, R; Zhang, A; Snowden, L

2001-11-01

Decentralization of California's public mental health system under program realignment has changed the utilization and cost of community-based mental health services. This study examined a sample of 75,951 users, representing 1.5 million adults who visited California's public mental health services during a 6-year period (FY 1988-1990 and FY 1992-1994). Regression analysis was performed to examine cost and utilization reduction over time, across regions, and across psychiatric diagnoses. Overall utilization and cost of community-based mental health services dropped significantly after the implementation of realignment. They were significantly lower for (a) 24-hour services in the urban industrialized Southern Region and (b) outpatient services in the agricultural Central Region of the state. Users diagnosed with mood disorders took a greater portion, but were associated with significantly less treatment and cost than other users in the post-realignment period. When local communities bear the financial risks and rewards, they find more efficient methods of delivering community-based mental health services.

Urban adolescent sexual and reproductive health in low-income and middle-income countries.

PubMed

Mmari, Kristin; Astone, Nan

2014-08-01

One of the most important aspects of adolescent health is sexual and reproductive health (SRH). Currently, sexually transmitted infections (STIs) threaten the health of adolescents more than any other age group, and as many as 2.2 million adolescents are living with HIV. Understanding adolescents' SRH needs and how to invest in improving their health can be best addressed by knowing more about the contexts that increase their vulnerability to poor sexual health outcomes. Recent evidence has highlighted an increasingly marginalised segment of the adolescent population--and that is the urban poor adolescent population in low and middle income countries (LMIC). Using an urban health framework, this paper examines the contextual factors within an urban community that influence the SRH of adolescents in LMIC. Findings show that while there is substantial research that has explored factors within the social environment, there is limited research that has explored factors within the physical environment, as well as research that has specifically explored urban adolescents' use of SRH services and how such services can be best provided to this vulnerable population. This paper highlights the need for further research to understand the relationships between the urban poor environment and the SRH risks that adolescents face while living in such environments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Rural Health Networks and Care Coordination: Health Care Innovation in Frontier Communities to Improve Patient Outcomes and Reduce Health Care Costs

PubMed Central

Conway, Pat; Favet, Heidi; Hall, Laurie; Uhrich, Jenny; Palcher, Jeanette; Olimb, Sarah; Tesch, Nathan; York-Jesme, Margaret; Bianco, Joe

2017-01-01

Rural residents’ health is challenged by high health care costs, chronic diseases, and policy decisions affecting rural health care. This single-case, embedded design study, guided by community-based participatory research principles and using mixed methods, describes outcomes of implementation of a community care team (CCT) and care coordination to improve outcomes of patients living in a frontier community. Seventeen organizations and 165 adults identified as potential care coordination candidates constituted the target populations. Following CCT development, collaboration and cohesion increased among organizations. Patients who participated in care coordination reported similar physical and lower emotional health quality of life than national counterparts; emergency department use decreased following care coordination. Key components identified as successful in urban settings seem applicable in rural settings, with emphasis on the key role of team facilitators; need for intense care coordination for people with complex health needs, especially behavioral health needs; and access to specialty care through technology. PMID:27818417

Taking action on the social determinants of health: improving health access for the urban poor in Mongolia

PubMed Central

2012-01-01

Introduction In recent years, the country of Mongolia (population 2.8 million) has experienced rapid social changes associated with economic growth, persisting socio-economic inequities and internal migration. In order to improve health access for the urban poor, the Ministry of Health developed a "Reaching Every District" strategy (RED strategy) to deliver an integrated package of key health and social services. The aim of this article is to present findings of an assessment of the implementation of the RED strategy, and, on the basis of this assessment, articulate lessons learned for equitable urban health planning. Methods Principal methods for data collection and analysis included literature review, barrier analysis of health access and in-depth interviews and group discussions with health managers and providers. Findings The main barriers to health access for the urban poor relate to interacting effects of poverty, unhealthy daily living environments, social vulnerability and isolation. Implementation of the RED strategy has resulted in increased health access for the urban poor, as demonstrated by health staff having reached new clients with immunization, family planning and ante-natal care services, and increased civil registrations which enable social service provision. Organizational effects have included improved partnerships for health and increased motivation of the health workforce. Important lessons learned from the early implementation of the RED strategy include the need to form strong partnerships among stakeholders at each level of the health system and in the community, as well as the need to develop a specific financing strategy to address the needs of the very poor. The diverse social context for health in an urban poor setting calls for a decentralized planning and partnership strategy, but with central level commitment towards policy guidance and financing of pro-poor urban health strategies. Conclusions Lessons from Mongolia mirror other international studies which point to the need to measure and take action on the social determinants of health at the local area level in order to adequately reduce persistent inequities in health care access for the urban poor. PMID:22429615

Disaster-related environmental health hazards: former lead smelting plants in the United States.

PubMed

Wang, Yao; Kanter, Robert K

2014-02-01

Natural disasters exacerbate risks of hazardous environmental exposures and adverse health consequences. The present study determined the proportion of previously identified lead industrial sites in urban locations that are at high risk for dispersal of toxic chemicals by natural disasters. Geographic analysis from publicly available data identified former lead smelting plants that coincide with populated urban areas and with high-risk locations for natural disasters. From a total of 229 urban smelting sites, 66 (29%) were in relatively high-risk areas for natural disasters: flood (39), earthquake (29), tornado (3), and hurricane (2). States with urban sites at relatively high risk for natural disaster included California (15); Pennsylvania (14); New York (7); Missouri (6); Illinois (5); New Jersey (4); Kentucky (3); Florida, Oregon, and Ohio (2 each); and Indiana, Massachusetts, Rhode Island, Texas, Utah, and Washington (1 each). Incomplete historical records showed at least 10 smelting site locations were affected by natural disaster. Forgotten environmental hazards may remain hazardous in any community. Uncertainty about risks in disasters causes disruptive public anxiety that increases difficulties in community responses and recovery. Our professional and public responsibility is to seek a better understanding of the risks of latent environmental hazards.

Urban forest management in New England: Towards a contemporary understanding of tree wardens in Massachusetts communities

USGS Publications Warehouse

Harper, Richard W.; Bloniarz, David V.; DeStefano, Stephen; Nicolson, Craig

2017-01-01

In the New England states, tree wardens are local officials responsible for the preservation, maintenance and stewardship of municipal public trees. This study explores the emerging professional challenges, duties and responsibilities of tree wardens, from the subject’s point of view, by conducting in-person, semi-structured qualitative research interviews with 50 tree wardens throughout Massachusetts. Many of the findings corroborate previous literature, including that tree wardens are typically housed in a municipal department (often public works or highway), that tree wardens routinely interact with a wide variety of local organisations (representatives from other municipal departments, community volunteer associations) and that as community size increases, tree wardens typically have access to a greater pool of resources to carry out urban forest management. A newer finding is that the subject of urban forest health arose as a topic of great importance for tree wardens, as nearly all interviewees (n = 49) indicated that they monitor for urban forest pests and that they would like further continuing education concerning this subject.

Spatial analysis of falls in an urban community of Hong Kong

PubMed Central

Lai, Poh C; Low, Chien T; Wong, Martin; Wong, Wing C; Chan, Ming H

2009-01-01

Background Falls are an issue of great public health concern. This study focuses on outdoor falls within an urban community in Hong Kong. Urban environmental hazards are often place-specific and dependent upon the built features, landscape characteristics, and habitual activities. Therefore, falls must be examined with respect to local situations. Results This paper uses spatial analysis methods to map fall occurrences and examine possible environmental attributes of falls in an urban community of Hong Kong. The Nearest neighbour hierarchical (Nnh) and Standard Deviational Ellipse (SDE) techniques can offer additional insights about the circumstances and environmental factors that contribute to falls. The results affirm the multi-factorial nature of falls at specific locations and for selected groups of the population. Conclusion The techniques to detect hot spots of falls yield meaningful results that enable the identification of high risk locations. The combined use of descriptive and spatial analyses can be beneficial to policy makers because different preventive measures can be devised based on the types of environmental risk factors identified. The analyses are also important preludes to establishing research hypotheses for more focused studies. PMID:19291326

Social-epidemiological study for evaluation of water supply and sanitation systems of low-income urban community in Dhaka, Bangladesh.

PubMed

Mollah, Kabirul A; Aramaki, Toshiya

2010-03-01

This study aims at quantification of health losses, considering social and environmental factors. Morbidity and mortality cases of diarrhoea for children under five years old were used to estimate the disability adjusted life years (DALYs) lost for the target households in low-income communities in Dhaka, Bangladesh. Water supply facilities and sanitation systems, along with hygiene practices and their health outcomes, were studied at community level. Demographic, socio-economic and socio-cultural aspects were also studied to support the research findings and give a better understanding of the local conditions. The four selected communities, Ward 60 (W60), Ward 61 (W61), Ward 62 (W62) and Ward 65 (W65), all had different existing urban services such as water supply, sanitation, garbage management and drainage facilities. All of these services existed in W62, but W60 did not have any of the services; W61 had sanitation and drainage coverage, whereas W65 had only a water supply facility. The results conclusively showed that, compared with the null (absence of services) scenario (W60), the other three scenarios (W61, W62 and W65) showed a substantial decrease of diarrhoea (1.219, 1.284 and 2.052 DALYs/household/year, respectively) reported for children under five years old. Besides urban services, other socio-economic characteristics might also influence the prevalence of diseases.