Developing a conceptual framework of urban health observatories toward integrating research and evidence into urban policy for health and health equity.

PubMed

Caiaffa, W T; Friche, A A L; Dias, M A S; Meireles, A L; Ignacio, C F; Prasad, A; Kano, M

2014-02-01

Detailed information on health linked to geographic, sociodemographic, and environmental data are required by city governments to monitor health and the determinants of health. These data are critical for guiding local interventions, resource allocation, and planning decisions, yet they are too often non-existent or scattered. This study aimed to develop a conceptual framework of Urban Health Observatories (UHOs) as an institutional mechanism which can help synthesize evidence and incorporate it into urban policy-making for health and health equity. A survey of a select group of existent UHOs was conducted using an instrument based on an a priori conceptual framework of key structural and functional characteristics of UHOs. A purposive sample of seven UHOs was surveyed, including four governmental, two non-governmental, and one university-based observatory, each from a different country. Descriptive and framework analysis methods were used to analyze the data and to refine the conceptual framework in light of the empirical data. The UHOs were often a product of unique historical circumstances. They were relatively autonomous and capable of developing their own locally sensitive agenda. They often had strong networks for accessing data and were able to synthesize them at the urban level as well as disaggregate them into smaller units. Some UHOs were identified as not only assessing but also responding to local needs. The findings from this study were integrated into a conceptual framework which illustrates how UHOs can play a vital role in monitoring trends in health determinants, outcomes, and equity; optimizing an intersectoral urban information system; incorporating research on health into urban policies and systems; and providing technical guidance on research and evidence-based policy making. In order to be most effective, UHOs should be an integral part of the urban governance system, where multiple sectors of government, the civil society, and businesses can participate in taking the right actions to promote health equity.

Is distribution of health expenditure in Iran pro-poor?

PubMed

Emamgholipour, Sara; Agheli, Lotfali

2018-05-03

The size and distribution of households' health care expenditure indicate the financial burden on different income groups. Since the distribution of health expenditure evaluates the performance of health systems, this study aims to examine the health expenditure distribution among urban and rural households in Iran. This research was conducted on the distribution of health expenditure among urban and rural households in 2014. The effects of households' health expenditure on distribution of personal incomes were measured by using Kakwani and Reynolds-Smolensky indices. In addition, Theil T index was used to classify provinces based on inequality in health expenditure distribution. The calculations were made by using EXCEL. The Kakwani indices for urban and rural households were calculated around -0.572 and -0.485, respectively. Reynolds-Smolensky indices for urban and rural households were measured as much as -0.038 and -0.031, respectively. Regardless of income distribution, Theil T index shows that urban households face with the most unequal distribution in health expenditure. Based on calculations, the distribution of health expenditure is against the poor households. In addition, this distribution is more regressive in urban than rural households. As well, Reynolds-Smolensky indices indicate more uneven income distribution after paying for health care, and inequality is larger among urban than rural households. To this research, the health policymaking priorities should be given to the provinces with the highest inequality, and the expenditure burden of low-income households should be reduced through expanding insurance coverage. Copyright © 2018 John Wiley & Sons, Ltd.

Including public-health benefits of trees in urban-forestry decision making

Treesearch

Geoffrey H. Donovan

2017-01-01

Research demonstrating the biophysical benefits of urban trees are often used to justify investments in urban forestry. Far less emphasis, however, is placed on the non-bio-physical benefits such as improvements in public health. Indeed, the public-health benefits of trees may be significantly larger than the biophysical benefits, and, therefore, failure to account for...

Rural–urban migration and mental and sexual health: a case study in Southwestern China

PubMed Central

Yang, Xiushi

2014-01-01

Massive rural–urban temporary migration has taken place amid China's rapid economic growth and development. Much has been written about the economic causes and consequences of this massive migration; less studied are the potential health and behavioral impacts of migration on migrants. Using data from a population-based sample survey conducted in southwestern China, this paper examines the potential impact of rural–urban migration and post-migration urban living on migrants' mental health and sexual risk behavior. The results suggest that regardless of places of origin and destination temporary migrants had on average poorer mental health and riskier sexual behavior than non-migrants. Compared to living in rural areas, living in urban areas does not make statistical difference in residents' mental health; it is only marginally associated with riskier sexual behavior. Rural–urban temporary migrants' mental health and health risk sexual behavior deserve more immediate research attention. Both selectivity of temporary migrants and migration-induced psycho-socio-behavioral changes may have contributed to migrants' poorer mental health and riskier sexual behavior. However, more theory-driven research with longitudinal design is needed before firm conclusions can be drawn about the underlying mechanisms that mediate or moderate the impact of temporary migration on migrants' mental health and sexual risk behavior. PMID:25932350

Exploring the linkages among urban form travel behavior and public health with person level data from smart phone applications.

DOT National Transportation Integrated Search

2013-09-01

The interaction between the built environment, travel behavior and public health is now a major concern for both : researchers and urban planners. Currently, there is little empirical research that explores and examines the : relationship between eac...

Urban heat stress: novel survey suggests health and fitness as future avenue for research and adaptation strategies

NASA Astrophysics Data System (ADS)

Schuster, Christian; Honold, Jasmin; Lauf, Steffen; Lakes, Tobia

2017-04-01

Extreme heat has tremendous adverse effects on human health. Heat stress is expected to further increase due to urbanization, an aging population, and global warming. Previous research has identified correlations between extreme heat and mortality. However, the underlying physical, behavioral, environmental, and social risk factors remain largely unknown and comprehensive quantitative investigation on an individual level is lacking. We conducted a new cross-sectional household questionnaire survey to analyze individual heat impairment (self-assessed and reported symptoms) and a large set of potential risk factors in the city of Berlin, Germany. This unique dataset (n = 474) allows for the investigation of new relationships, especially between health/fitness and urban heat stress. Our analysis found previously undocumented associations, leading us to generate new hypotheses for future research: various health/fitness variables returned the strongest associations with individual heat stress. Our primary hypothesis is that age, the most commonly used risk factor, is outperformed by health/fitness as a dominant risk factor. Related variables seem to more accurately represent humans’ cardiovascular capacity to handle elevated temperature. Among them, active travel was associated with reduced heat stress. We observed statistical associations for heat exposure regarding the individual living space but not for the neighborhood environment. Heat stress research should further investigate individual risk factors of heat stress using quantitative methodologies. It should focus more on health and fitness and systematically explore their role in adaptation strategies. The potential of health and fitness to reduce urban heat stress risk means that encouraging active travel could be an effective adaptation strategy. Through reduced CO2 emissions from urban transport, societies could reap double rewards by addressing two root causes of urban heat stress: population health and global warming.

Research on Relationship Among Internet-Addiction, Personality Traits and Mental Health of Urban Left-Behind Children

PubMed Central

Ge, Ying; Se, Jun; Zhang, Jingfu

2015-01-01

Aim: In this research, we attempted at exploring the relationships among urban left-behind children’s internet-addiction, personality traits and mental health. Methods: In the form of three relevant questionnaires (Adolescent Pathological Internet Use Scale, Eysenck Personality Questionnaire, Children’s Edition in Chinese and Mental Health Test), 796 urban left-behind children in China were investigated, concerning internet-addiction, personality traits and mental health. Results: (1) The internet-addiction rate of urban left-behind children in China reached10.8%—a relatively high figure, with the rate among males higher than that among females. In terms of internet-addition salience, the figure of urban left-behind children was obviously higher than that of non-left-behind children. (2) In China, the personality deviation rate of the overall left-behind children was 15.36%; while the personality deviation rate of the internet-addicted urban left-behind children was 38.88%, a figure prominently higher than that of the non-addicted urban left-behind children group, with the rate among females higher than that among males. (3) The mental health problem rate of the overall urban left-behind children in China was 8.43%; while the rate of the internet-addicted urban left-behind children was 27.77%, a figure significantly higher than that of the non-addicted urban left-behind children. (4) There were significant relationships among internet-addiction, personality traits and mental health. The total score of internet-addiction and its related dimensions can serve as indicators of personality neuroticism, psychoticism and the total scores of mental health. PMID:25946911

Links between the built environment, climate and population health: interdisciplinary environmental change research in New York City.

PubMed

Rosenthal, Joyce Klein; Sclar, Elliott D; Kinney, Patrick L; Knowlton, Kim; Crauderueff, Robert; Brandt-Rauf, Paul W

2007-10-01

Global climate change is expected to pose increasing challenges for cities in the following decades, placing greater stress and impacts on multiple social and biophysical systems, including population health, coastal development, urban infrastructure, energy demand, and water supplies. Simultaneously, a strong global trend towards urbanisation of poverty exists, with increased challenges for urban populations and local governance to protect and sustain the wellbeing of growing cities. In the context of these 2 overarching trends, interdisciplinary research at the city scale is prioritised for understanding the social impacts of climate change and variability and for the evaluation of strategies in the built environment that might serve as adaptive responses to climate change. This article discusses 2 recent initiatives of The Earth Institute at Columbia University (EI) as examples of research that integrates the methods and objectives of several disciplines, including environmental health science and urban planning, to understand the potential public health impacts of global climate change and mitigative measures for the more localised effects of the urban heat island in the New York City metropolitan region. These efforts embody 2 distinct research approaches. The New York Climate & Health Project created a new integrated modeling system to assess the public health impacts of climate and land use change in the metropolitan region. The Cool City Project aims for more applied policy-oriented research that incorporates the local knowledge of community residents to understand the costs and benefits of interventions in the built environment that might serve to mitigate the harmful impacts of climate change and variability, and protect urban populations from health stressors associated with summertime heat. Both types of research are potentially useful for understanding the impacts of environmental change at the urban scale, the policies needed to address these challenges, and to train scholars capable of collaborative approaches across the social and biophysical sciences.

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 NSF-RCN Urban Heat Island Network

NASA Astrophysics Data System (ADS)

Twine, T. E.; Snyder, P. K.; Hamilton, P.; Shepherd, M.; Stone, B., Jr.

2014-12-01

In much of the world cities are warming at twice the rate of outlying rural areas. The frequency of urban heat waves is projected to increase with climate change through the 21stcentury. Addressing the economic, environmental, and human costs of urban heat islands requires a better understanding of their behavior from many disciplinary perspectives. The goal of this four-year Urban Heat Island Network is to (1) bring together scientists studying the causes and impacts of urban warming, (2) advance multidisciplinary understanding of urban heat islands, (3) examine how they can be ameliorated through engineering and design practices, and (4) share these new insights with a wide array of stakeholders responsible for managing urban warming to reduce their health, economic, and environmental impacts. The Urban Heat Island Network involves atmospheric scientists, engineers, architects, landscape designers, urban planners, public health experts, and education and outreach experts, who will share knowledge, evaluate research directions, and communicate knowledge and research recommendations to the larger research community as well as stakeholders engaged in developing strategies to adapt to and mitigate urban warming. The first Urban Climate Institute was held in Saint Paul, Minnesota in July 2013 and focused on the characteristics of urban heat islands. Scientists engaged with local practitioners to improve communication pathways surrounding issues of understanding, adapting to, and mitigating urban warming. The second Urban Climate Institute was held in Atlanta, Georgia in July 2014 and focused on urban warming and public health. Scientists discussed the state of the science on urban modeling, heat adaptation, air pollution, and infectious disease. Practitioners informed participants on emergency response methods and protocols related to heat and other extreme weather events. Evaluation experts at the Science Museum of Minnesota have extensively evaluated both Institutes to improve future Institutes and to inform other research coordination networks. Two more Institutes are planned for 2015 and 2016 focusing on urban warming and the built environment, and education and outreach.

The health benefits of nature-based solutions to urbanization challenges for children and the elderly - A systematic review.

PubMed

Kabisch, Nadja; van den Bosch, Matilda; Lafortezza, Raffaele

2017-11-01

Urban green and blue spaces promote health by offering areas for physical activity, stress relief, and social interaction, which may be considered as cultural ecosystem services. They also provide a number of regulating ecosystem services that can be regarded as nature-based solutions to mitigate impacts from urbanization-induced challenges. Urban trees and other vegetation provide cooling through shade and evapotranspiration, which reduce the impact of the urban heat island on hot summer days. Urban vegetation may improve air quality by removing air pollutants. Open areas in cities, such as parks, gardens, playgrounds and cemeteries, are unsealed spaces that also improve infiltration during extreme precipitation events providing water regulating functions. All these services have the potential to improve the health of urban residents, particularly of specific vulnerable groups such as children and the elderly. The aim of this paper is to provide an overview of the current state of evidence on the relationship between the health of children and the elderly and urban green and blue spaces that can account as nature-based solutions to urbanization-induced challenges. We discuss potential confounding factors and refer to the different green space metrics used to identify associations to health. From the results, we cannot conclude on a universal protective health effect of urban green and blue spaces for children and the elderly. While the association trend is positive, the results remain inconclusive, context dependent and are partly overridden by socioeconomic confounders. However, the research area is consistently increasing, and we advance important prospects for future research on urban green and blue spaces in the face of global challenges such as urbanization. Copyright © 2017 Elsevier Inc. All rights reserved.

Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health

PubMed Central

Jennings, Viniece; Larson, Lincoln; Yun, Jessica

2016-01-01

Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice. PMID:26861365

Advancing Sustainability through Urban Green Space: Cultural Ecosystem Services, Equity, and Social Determinants of Health.

PubMed

Jennings, Viniece; Larson, Lincoln; Yun, Jessica

2016-02-05

Urban green spaces provide an array of benefits, or ecosystem services, that support our physical, psychological, and social health. In many cases, however, these benefits are not equitably distributed across diverse urban populations. In this paper, we explore relationships between cultural ecosystem services provided by urban green space and the social determinants of health outlined in the United States Healthy People 2020 initiative. Specifically, we: (1) explore connections between cultural ecosystem services and social determinants of health; (2) examine cultural ecosystem services as nature-based health amenities to promote social equity; and (3) recommend areas for future research examining links between urban green space and public health within the context of environmental justice.

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 NSF-RCN Urban Heat Island Network

NASA Astrophysics Data System (ADS)

Twine, T. E.; Snyder, P. K.; Hamilton, P.; Shepherd, M.; Stone, B., Jr.

2015-12-01

In much of the world cities are warming at twice the rate of outlying rural areas. The frequency of urban heat waves is projected to increase with climate change through the 21st century. Addressing the economic, environmental, and human costs of urban heat islands requires a better understanding of their behavior from many disciplinary perspectives. The goal of this four-year Urban Heat Island Network is to (1) bring together scientists studying the causes and impacts of urban warming, (2) advance multidisciplinary understanding of urban heat islands, (3) examine how they can be ameliorated through engineering and design practices, and (4) share these new insights with a wide array of stakeholders responsible for managing urban warming to reduce their health, economic, and environmental impacts. The NSF-RCN Urban Heat Island Network involves atmospheric scientists, engineers, architects, landscape designers, urban planners, public health experts, and education and outreach experts, who will share knowledge, evaluate research directions, and communicate knowledge and research recommendations to the larger research community as well as stakeholders engaged in developing strategies to adapt to and mitigate urban warming. The first Urban Climate Institute was held in Saint Paul, MN in July 2013 and focused on the characteristics of urban heat islands. Scientists engaged with local practitioners to improve communication pathways surrounding issues of understanding, adapting to, and mitigating urban warming. The second Urban Climate Institute was held in Atlanta, Georgia in July 2014 and focused on urban warming and public health. The third Urban Climate Institute was held in Athens, GA in July 2015 and focused on urban warming and the role of the built environment. Scientists and practitioners discussed strategies for mitigation and adaptation. Evaluation experts at the Science Museum of Minnesota have extensively evaluated the Institutes to inform other research coordination networks and to identify effective ways that researchers and practitioners can share knowledge and communicate more effectively. A final Institute is planned for July of 2016 in Saint Paul, MN. This institute will focus on synthesizing findings from the first three workshops and discuss education and outreach efforts.

A Case Study Examining Undergraduate Public Health Student Experiences at a Large, Private, Urban Research University

ERIC Educational Resources Information Center

Baillie, Colleen P.

2017-01-01

Undergraduate students represent a new but growing population at a school of public (SPH) health at a large, private, urban research university on the East Coast. This SPH has offered a minor in public health since 2010, and a major was initiated in 2014. The school also plans to offer an accelerated bachelor's-to-master's in public health…

Spatial Accessibility to Health Care Services: Identifying under-Serviced Neighbourhoods in Canadian Urban Areas

PubMed Central

Shah, Tayyab Ikram; Bell, Scott; Wilson, Kathi

2016-01-01

Background Urban environments can influence many aspects of health and well-being and access to health care is one of them. Access to primary health care (PHC) in urban settings is a pressing research and policy issue in Canada. Most research on access to healthcare is focused on national and provincial levels in Canada; there is a need to advance current understanding to local scales such as neighbourhoods. Methods This study examines spatial accessibility to family physicians using the Three-Step Floating Catchment Area (3SFCA) method to identify neighbourhoods with poor geographical access to PHC services and their spatial patterning across 14 Canadian urban settings. An index of spatial access to PHC services, representing an accessibility score (physicians-per-1000 population), was calculated for neighborhoods using a 3km road network distance. Information about primary health care providers (this definition does not include mobile services such as health buses or nurse practitioners or less distributed services such as emergency rooms) used in this research was gathered from publicly available and routinely updated sources (i.e. provincial colleges of physicians and surgeons). An integrated geocoding approach was used to establish PHC locations. Results The results found that the three methods, Simple Ratio, Neighbourhood Simple Ratio, and 3SFCA that produce City level access scores are positively correlated with each other. Comparative analyses were performed both within and across urban settings to examine disparities in distributions of PHC services. It is found that neighbourhoods with poor accessibility scores in the main urban settings across Canada have further disadvantages in relation to population high health care needs. Conclusions The results of this study show substantial variations in geographical accessibility to PHC services both within and among urban areas. This research enhances our understanding of spatial accessibility to health care services at the neighbourhood level. In particular, the results show that the low access neighbourhoods tend to be clustered in the neighbourhoods at the urban periphery and immediately surrounding the downtown area. PMID:27997577

Emergy-based urban ecosystem health assessment: A case study of Baotou, China

NASA Astrophysics Data System (ADS)

Liu, G. Y.; Yang, Z. F.; Chen, B.; Zhang, Y.; Zhang, L. X.; Zhao, Y. W.; Jiang, M. M.

2009-03-01

Ecosystem health has been a hot topic of ecosystem management research for years. Considering the urban area as a complex ecosystem consisted of natural, societal and economic entities, urban ecosystem health assessment is necessary to be conducted for the scientific management and proper ecological restoration. Combining with the ecosystem service function of the urban ecosystem, theoretical framework and methodology of the urban ecosystem health assessment based on emergy are proposed and the temporal variation of the health level of the city are also outlined in this paper. Following the principle of ecosystem health assessment, four major factors, including vigor (V), organizational structure (O), resilience (R) and function maintenance (F), are integrated to construct a novel emergy-based urban ecosystem health index (EUEHI). Based on the EUEHI and comparing with those of five other typical Chinese cities, the case study of Baotou city shows that its urban ecosystem health level is steadily arising despite the year 2001 as a turning point. Due to the emphasis on the resource structure adjustment and utilization efficiency, Baotou has obtained a better organizational structure and service function for the total urban ecosystem.

Urbanisation and health in China

PubMed Central

Gong, Peng; Liang, Song; Carlton, Elizabeth J; Jiang, Qingwu; Wu, Jianyong; Wang, Lei; Remais, Justin V

2013-01-01

China has seen the largest human migration in history, and the country's rapid urbanisation has important consequences for public health. A provincial analysis of its urbanisation trends shows shifting and accelerating rural-to-urban migration across the country and accompanying rapid increases in city size and population. The growing disease burden in urban areas attributable to nutrition and lifestyle choices is a major public health challenge, as are troubling disparities in health-care access, vaccination coverage, and accidents and injuries in China's rural-to-urban migrant population. Urban environmental quality, including air and water pollution, contributes to disease both in urban and in rural areas, and traffic-related accidents pose a major public health threat as the country becomes increasingly motorised. To address the health challenges and maximise the benefits that accompany this rapid urbanisation, innovative health policies focused on the needs of migrants and research that could close knowledge gaps on urban population exposures are needed. PMID:22386037

Indigenous Māori perspectives on urban transport patterns linked to health and wellbeing.

PubMed

Raerino Ngāti Awa Te Arawa, K; Macmillan, Alex K; Jones Ngāti Kahungunu, Rhys G

2013-09-01

There is a growing body of research linking urban transport systems to inequities in health. However, there is a lack of research providing evidence of the effect of transport systems on indigenous family wellbeing. We examined the connections between urban transport and the health and wellbeing of Māori, the indigenous people of New Zealand. We provide an indigenous exploration of current urban transport systems, with a particular focus on the impacts of car dependence and the need for culturally relevant travel. We interviewed nineteen Māori participants utilising qualitative research techniques underpinned by an indigenous research methodology (Kaupapa Māori). The data highlighted the importance of accessing cultural activities and sites relevant to 'being Māori', and issues with affordability and safety of public transport. Understanding the relationship between indigenous wellbeing and transport systems that goes further than limited discourses of inequity is essential to improving transport for indigenous wellbeing. Providing an indigenous voice in transport decision-making will make it more likely that indigenous health and wellbeing is prioritised in transport planning. Copyright © 2013. Published by Elsevier Ltd.

Urban Green Space and Its Impact on Human Health

Treesearch

Michelle Kondo; Jaime Fluehr; Thomas McKeon; Charles Branas

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...

Shades of green: Measuring the ecology of urban green space in the context of human health and well-being

Treesearch

Anna Jorgensen; Paul H. Gobster

2010-01-01

In this paper we review and analyze the recent research literature on urban green space and human health and well-being, with an emphasis on studies that attempt to measure biodiversity and other green space concepts relevant to urban ecological restoration. We first conduct a broad scale assessment of the literature to identify typologies of urban green space and...

Determinants of Medical and Health Care Expenditure Growth for Urban Residents in China: A Systematic Review Article.

PubMed

Zhu, Xiaolong; Cai, Qiong; Wang, Jin; Liu, Yun

2014-12-01

In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China's health care system, benefiting the country, society and every household. This paper employs panel data from China's provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index) of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research.

Social Stigma and Mental Health among Rural-to-Urban Migrants in China: A Conceptual Framework and Future Research Needs

PubMed Central

Li, Xiaoming; Stanton, Bonita; Fang, Xiaoyi; Lin, Danhua

2007-01-01

There are over 100 million individuals in China who have migrated from rural villages to urban areas for jobs or better lives without permanent urban residency (e.g., “rural-to-urban migrants”). Our preliminary data from ongoing research among rural-to-urban migrants in China suggest that the migrant population is strongly stigmatized. Moreover, it appears that substantial numbers of these migrants experience mental health symptoms (e.g., depression, anxiety, hostility, social isolation). While the population potentially affected is substantial (more than 9% of the entire population or about one-quarter of the rural labor in mainland China) and our data seem to indicate that the issue is pervasive in this population, there is limited literature on the topic in China or elsewhere. Therefore, in the current article, we utilize secondary data from public resources (e.g., scientific literature, governmental publication, public media) and our own qualitative data to explore the issues of stigmatization and mental health, to propose a conceptual model for studying the association between the stigmatization and mental health among this population, and to identify some future needs of research in this area. PMID:18277106

Understanding the health impacts of urbanization in China: A living laboratory for urban biogeochemistry research

NASA Astrophysics Data System (ADS)

Zhu, Y. G.

2015-12-01

China has the largest population in the world, and by 2011, more than 50% of its population are now living in cities. This ongoing societal change has profound impacts on environmental quality and population health. In addition to intensive discharges of waste, urbanization is not only changing the land use and land cover, but also inducing fundamental changes in biogeochemical processes. Unlike biogeochemistry in non-urban environment, the biological component of urban biogeochemistry is dominated by direct human activities, such as air pollution derived from transport, wastewater treatment, garbage disposal and increase in impervious surface etc. Managing urban biogeochemistry will include source control over waste discharge, eco-infrastructure (such as green space and eco-drainage), resource recovery from urban waste stream, and integration with peri-urban ecosystem, particularly with food production system. The overall goal of managing urban biogeochemistry is for human health and wellbeing, which is a global challenge. In this paper, the current status of urban biogeochemistry research in China will be briefly reviewed, and then it will focus on nutrient recycling and waste management, as these are the major driving forces of environmental quality changes in urban areas. This paper will take a holistic view on waste management, covering urban metabolism analysis, technological innovation and integration for resource recovery from urban waste stream, and risk management related to waste recycling and recovery.

Traversing Urban Social Spaces: How Online Research Helps Unveil Offline Practice

NASA Astrophysics Data System (ADS)

Carroll, Julie-Anne; Foth, Marcus; Adkins, Barbara

This article presents a discussion of methodological considerations in urban informatics research. As an exemplar, we examine a health communication research blog set up to produce insights into the choices made by residents of a master-planned development affecting their health and well-being. It served both as a repository for collection and a tool for the strategic selection and analysis of internet research data. We reflect on the nature of the online data contributed by an urban demographic about their physical activity practices within this particular neighbourhood. The blog provided a forum for detailed responses which allowed participants to reflect on their answers over a period of time, and write with the privacy and protection effects provided by the anonymity of contributions, coupled with the advantage of being able to view the contributions made by other residents. Opinions, stories and discussions were instigated by questions and photographs posted on the blog about residents' levels of engagement with the neighbourhood for staying active and healthy. Residents reported on the social and physical aspects of the new urban environment that either encouraged or inhibited them from leading active and healthy lifestyles. In this context the blog provided insights into the role of both the planning rhetoric associated with a new urban village and the meanings attached to the lifeworld of the residents in their health practices. A total of 214 contributions to the blog were made by the residents, with the analysis and findings highlighting implications for urban design and health promotion research and practice.

Too Costly To Be Ill: Health Care Access and Health Seeking Behaviors among Rural-to-urban Migrants in China

PubMed Central

Hong, Yan; Li, Xiaoming; Stanton, Bonita; Lin, Danhua; Fang, Xiaoyi; Rong, Mao; Wang, Jing

2007-01-01

Of the 114 million rural-to-urban migrants in China, most have only temporary employment in the cities. Because of their non-urban residence, they are not entitled to many benefits and services accorded to most urban dwellers. Only limited research has been conducted on the health care access and health seeking behaviors of this population. This study, based on qualitative data from in-depth interviews with 90 rural-to-urban migrants, found that migrants had limited access to regular medical services. Lack of insurance coverage, high cost, and exacting work schedules have resulted in use of unsupervised self-treatment or substandard care. Their health seeking behaviors have led to suboptimal health consequences including delayed treatment of illnesses. Findings from this study underscore the importance of reducing institutional barriers to health services and providing affordable health care to this population. PMID:18277099

Roundtable on Urban Living Environment Research (RULER).

PubMed

Vlahov, David; Agarwal, Siddharth Raj; Buckley, Robert M; Caiaffa, Waleska Teixeira; Corvalan, Carlos F; Ezeh, Alex Chika; Finkelstein, Ruth; Friel, Sharon; Harpham, Trudy; Hossain, Maharufa; de Faria Leao, Beatriz; Mboup, Gora; Montgomery, Mark R; Netherland, Julie C; Ompad, Danielle C; Prasad, Amit; Quinn, Andrew T; Rothman, Alexander; Satterthwaite, David E; Stansfield, Sally; Watson, Vanessa J

2011-10-01

For 18 months in 2009-2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO's Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health-namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.

Urbanisation and health in China.

PubMed

Gong, Peng; Liang, Song; Carlton, Elizabeth J; Jiang, Qingwu; Wu, Jianyong; Wang, Lei; Remais, Justin V

2012-03-03

China has seen the largest human migration in history, and the country's rapid urbanisation has important consequences for public health. A provincial analysis of its urbanisation trends shows shifting and accelerating rural-to-urban migration across the country and accompanying rapid increases in city size and population. The growing disease burden in urban areas attributable to nutrition and lifestyle choices is a major public health challenge, as are troubling disparities in health-care access, vaccination coverage, and accidents and injuries in China's rural-to-urban migrant population. Urban environmental quality, including air and water pollution, contributes to disease both in urban and in rural areas, and traffic-related accidents pose a major public health threat as the country becomes increasingly motorised. To address the health challenges and maximise the benefits that accompany this rapid urbanisation, innovative health policies focused on the needs of migrants and research that could close knowledge gaps on urban population exposures are needed. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

Brief introductory guide to agent-based modeling and an illustration from urban health research.

PubMed

Auchincloss, Amy H; Garcia, Leandro Martin Totaro

2015-11-01

There is growing interest among urban health researchers in addressing complex problems using conceptual and computation models from the field of complex systems. Agent-based modeling (ABM) is one computational modeling tool that has received a lot of interest. However, many researchers remain unfamiliar with developing and carrying out an ABM, hindering the understanding and application of it. This paper first presents a brief introductory guide to carrying out a simple agent-based model. Then, the method is illustrated by discussing a previously developed agent-based model, which explored inequalities in diet in the context of urban residential segregation.

Brief introductory guide to agent-based modeling and an illustration from urban health research

PubMed Central

Auchincloss, Amy H.; Garcia, Leandro Martin Totaro

2017-01-01

There is growing interest among urban health researchers in addressing complex problems using conceptual and computation models from the field of complex systems. Agent-based modeling (ABM) is one computational modeling tool that has received a lot of interest. However, many researchers remain unfamiliar with developing and carrying out an ABM, hindering the understanding and application of it. This paper first presents a brief introductory guide to carrying out a simple agent-based model. Then, the method is illustrated by discussing a previously developed agent-based model, which explored inequalities in diet in the context of urban residential segregation. PMID:26648364

Monitoring of health and demographic outcomes in poor urban settlements: evidence from the Nairobi Urban Health and Demographic Surveillance System.

PubMed

Emina, Jacques; Beguy, Donatien; Zulu, Eliya M; Ezeh, Alex C; Muindi, Kanyiva; Elung'ata, Patricia; Otsola, John K; Yé, Yazoumé

2011-06-01

The Nairobi Urban Health and Demographic Surveillance System (NUHDSS) was set up in Korogocho and Viwandani slum settlements to provide a platform for investigating linkages between urban poverty, health, and demographic and other socioeconomic outcomes, and to facilitate the evaluation of interventions to improve the wellbeing of the urban poor. Data from the NUHDSS confirm the high level of population mobility in slum settlements, and also demonstrate that slum settlements are long-term homes for many people. Research and intervention programs should take account of the duality of slum residency. Consistent with the trends observed countrywide, the data show substantial improvements in measures of child mortality, while there has been limited decline in fertility in slum settlements. The NUHDSS experience has shown that it is feasible to set up and implement long-term health and demographic surveillance system in urban slum settlements and to generate vital data for guiding policy and actions aimed at improving the wellbeing of the urban poor.

Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning

PubMed Central

Mills, Freya; Petterson, Susan; Norman, Guy

2018-01-01

Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed, this research identified gaps in their ability to predict faecal pathogen flows, to relate exposure risks to the existing sanitation services, and to compare expected impacts of improvements. This paper outlines a conceptual approach that links faecal waste discharge patterns with potential pathogen exposure pathways to quantitatively compare urban sanitation improvement options. An illustrative application of the approach is presented, using a spreadsheet-based model to compare the relative effect on disability-adjusted life years of six sanitation improvement options for a hypothetical urban situation. The approach includes consideration of the persistence or removal of different pathogen classes in different environments; recognition of multiple interconnected sludge and effluent pathways, and of multiple potential sites for exposure; and use of quantitative microbial risk assessment to support prediction of relative health risks for each option. This research provides a step forward in applying current knowledge to better consider public health, alongside environmental and other objectives, in urban sanitation decision making. Further empirical research in specific locations is now required to refine the approach and address data gaps. PMID:29360775

Urban health in daily practice: livelihood, vulnerability and resilience in Dar es Salaam, Tanzania.

PubMed

Obrist, Brigit

2003-12-01

Health is the core value and ultimate goal of health development, yet we know very little about health conceptions in everyday life. Inspired by investigations into lay health concepts in Europe, our study explores experiences and meanings of health in a strikingly different context, namely, in a low-income neighbourhood of an African city. Grounded in ethnographic research in Dar es Salaam, we introduce the concept of 'health practice' and examine health definitions, explanations, and activities of urban Swahili women. Our findings show that representations of health form a set of experiences, meanings and embodied practice centring on the links between body, mind, and living conditions. We suggest that 'livelihood', 'vulnerability' and 'resilience' best capture women's main concerns of health practice in such a setting. All women face an emotional burden of being exposed to urban afflictions and an intellectual and practical burden of overcoming them, but some meet this challenge more successfully than others do. This approach tips the balance towards a positive view of health that has been neglected in medical anthropology. It also opens new lines of inquiry in urban health research by consequently following a resource orientation that acknowledges women's struggle to stay healthy and directs attention to their agency.

Determinants of Medical and Health Care Expenditure Growth for Urban Residents in China: A Systematic Review Article

PubMed Central

ZHU, Xiaolong; CAI, Qiong; WANG, Jin; LIU, Yun

2014-01-01

In recent years, medical and health care consumption has risen, making health risk an important determinant of household spending and welfare. We aimed to examine the determinants of medical and health care expenditure to help policy-makers in the improvement of China’s health care system, benefiting the country, society and every household. This paper employs panel data from China’s provinces from 2001 to 2011 with all possible economic variations and studies the determinants of medical and healthcare expenditure for urban residents. CPI (consumer price index) of medical services and the resident consumption level of urban residents have positive influence on medical and health care expenditures for urban residents, while the local medical budget, the number of health institutions, the incidence of infectious diseases, the year-end population and the savings of urban residents will not have effect on medical and health care expenditure for urban residents. This paper proposed three relevant policy suggestions for Chinese governments based on the findings of the research. PMID:26171351

Looking within and beyond the community: lessons learned by researching, theorising and acting to address urban poverty and health.

PubMed

Hodgetts, Darrin; Chamberlain, Kerry; Tankel, Yadena; Groot, Shiloh

2014-01-01

Urban poverty and health inequalities are inextricably intertwined. By working in partnership with service providers and communities to address urban poverty, we can enhance the wellness of people in need. This article reflects on lessons learned from the Family100 project that explores the everyday lives, frustrations and dilemmas faced by 100 families living in poverty in Auckland. Lessons learned support the need to bring the experiences and lived realities of families to the fore in public deliberations about community and societal responses to urban poverty and health inequality.

The Pan-University Network for Global Health: framework for collaboration and review of global health needs.

PubMed

Winchester, M S; BeLue, R; Oni, T; Wittwer-Backofen, U; Deobagkar, D; Onya, H; Samuels, T A; Matthews, S A; Stone, C; Airhihenbuwa, C

2016-04-21

In the current United Nations efforts to plan for post 2015-Millennium Development Goals, global partnership to address non-communicable diseases (NCDs) has become a critical goal to effectively respond to the complex global challenges of which inequity in health remains a persistent challenge. Building capacity in terms of well-equipped local researchers and service providers is a key to bridging the inequity in global health. Launched by Penn State University in 2014, the Pan University Network for Global Health responds to this need by bridging researchers at more than 10 universities across the globe. In this paper we outline our framework for international and interdisciplinary collaboration, as well the rationale for our research areas, including a review of these two themes. After its initial meeting, the network has established two central thematic priorities: 1) urbanization and health and 2) the intersection of infectious diseases and NCDs. The urban population in the global south will nearly double in 25 years (approx. 2 billion today to over 3.5 billion by 2040). Urban population growth will have a direct impact on global health, and this growth will be burdened with uneven development and the persistence of urban spatial inequality, including health disparities. The NCD burden, which includes conditions such as hypertension, stroke, and diabetes, is outstripping infectious disease in countries in the global south that are considered to be disproportionately burdened by infectious diseases. Addressing these two priorities demands an interdisciplinary and multi-institutional model to stimulate innovation and synergy that will influence the overall framing of research questions as well as the integration and coordination of research.

Bringing sexual and reproductive health in the urban contexts to the forefront of the development agenda: the case for prioritizing the urban poor.

PubMed

Mberu, Blessing; Mumah, Joyce; Kabiru, Caroline; Brinton, Jessica

2014-09-01

Estimates suggest that over 90 % of population increase in the least developed countries over the next four decades will occur in urban areas. These increases will be driven both by natural population growth and rural-urban migration. Moreover, despite its status as the world's least urbanized region, the urban population in the sub-Saharan Africa region is projected to increase from under 40 % currently to over 60 % by 2050. Currently, approximately 70 % of all urban residents in the region live in slums or slum-like conditions. Sexual and reproductive health (SRH) risks for the urban poor are severe and include high rates of unwanted pregnancies, sexually transmitted infections, and poor maternal and child health outcomes. However, the links between poverty, urbanization, and reproductive health priorities are still not a major focus in the broader development agenda. Building on theoretical and empirical data, we show that SRH in urban contexts is critical to the development of healthy productive urban populations and, ultimately, the improvement of quality of life. We posit that a strategic focus on the sexual and reproductive health of urban residents will enable developing country governments achieve international goals and national targets by reducing health risks among a large and rapidly growing segment of the population. To that end, we identify key research, policy and program recommendations and strategies required for bringing sexual and reproductive health in urban contexts to the forefront of the development agenda.

Priorities and needs for research on urban interventions targeting vector-borne diseases: rapid review of scoping and systematic reviews.

PubMed

Bermudez-Tamayo, Clara; Mukamana, Olive; Carabali, Mabel; Osorio, Lyda; Fournet, Florence; Dabiré, Kounbobr Roch; Turchi Marteli, Celina; Contreras, Adolfo; Ridde, Valéry

2016-12-01

This paper highlights the critical importance of evidence on vector-borne diseases (VBD) prevention and control interventions in urban settings when assessing current and future needs, with a view to setting policy priorities that promote inclusive and equitable urban health services. Research should produce knowledge about policies and interventions that are intended to control and prevent VBDs at the population level and to reduce inequities. Such interventions include policy, program, and resource distribution approaches that address the social determinants of health and exert influence at organizational and system levels.

Urban-rural status affects associations between domains of environmental quality and adverse birth outcomes

EPA Science Inventory

The relationship between environmental conditions and human health varies by environmental domain and urbanicity. To account for multiple ambient environmental conditions, we constructed an Environmental Quality Index (EQI) for health research. We used U.S. county level data rep...

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control

PubMed Central

Beyere, Christopher B.; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P.

2017-01-01

Background The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. Methods This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Results Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. Conclusions There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards. PMID:28982194

Perceived needs of health tutors in rural and urban health training institutions in Ghana: Implications for health sector staff internal migration control.

PubMed

Alhassan, Robert Kaba; Beyere, Christopher B; Nketiah-Amponsah, Edward; Mwini-Nyaledzigbor, Prudence P

2017-01-01

The population of Ghana is increasingly becoming urbanized with about 70% of the estimated 27 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32% of the national health sector workforce works. Moreover, the rural-urban disparities in the density of health tutors (staff responsible for pre-service training of health professionals) are enormous. This paper explores perceived needs of health tutors in rural and urban health training institutions in Ghana. This is a descriptive qualitative study conducted in the Greater Accra and Northern regions of Ghana. The Study used the deductive thematic and sub-thematic analysis approaches. Five health training institutions were randomly sampled, and 72 tutors engaged in separate focus group discussions with an average size of 14 participants per group in each training institution. Perceived rural-urban disparities among health tutors were found in the payment of extra duty allowances; school infrastructure including libraries and internet connectivity; staff accommodation; and opportunities for scholarships and higher education. Health tutors in rural areas generally expressed more frustration with these work conditions than those in urban areas. There is the need to initiate and sustain work incentives that promote motivation of rural health tutors to control ongoing rural-urban migration of qualified staff. It is recommended the following incentives be prioritized to promote retention of qualified health tutors in rural health training schools: payment of research, book and rural allowances; early promotion of rural staff; prioritizing rural tutors for scholarships, and introduction of national best health tutor awards.

Evidence-Based Research on the Value of School Nurses in an Urban School System

ERIC Educational Resources Information Center

Baisch, Mary J.; Lundeen, Sally P.; Murphy, M. Kathleen

2011-01-01

Background: With the increasing acuity of student health problems, growing rates of poverty among urban families, and widening racial/ethnic health disparities in child and adolescent health indicators, the contributions of school nurses are of increasing interest to policymakers. This study was conducted to evaluate the impact of school nurses on…

Toward a New Model for Promoting Urban Children's Mental Health: Accessible, Effective, and Sustainable School-Based Mental Health Services

ERIC Educational Resources Information Center

Atkins, Marc S.; Graczyk, Patricia A.; Frazier, Stacy L.; Abdul-Adil, Jaleel

2003-01-01

A program of research related to school-based models for urban children's mental health is described, with a particular focus on improving access to services, promoting children's functioning, and providing for program sustainability. The first study in this series responded to the urgent need to engage more families in mental health services, and…

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

Differences in health care seeking behaviour between rural and urban communities in South Africa

PubMed Central

2012-01-01

Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Conclusion Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour. PMID:22691443

Public Health Adaptation to Climate Change in Large Cities: A Global Baseline.

PubMed

Araos, Malcolm; Austin, Stephanie E; Berrang-Ford, Lea; Ford, James D

2016-01-01

Climate change will have significant impacts on human health, and urban populations are expected to be highly sensitive. The health risks from climate change in cities are compounded by rapid urbanization, high population density, and climate-sensitive built environments. Local governments are positioned to protect populations from climate health risks, but it is unclear whether municipalities are producing climate-adaptive policies. In this article, we develop and apply systematic methods to assess the state of public health adaptation in 401 urban areas globally with more than 1 million people, creating the first global baseline for urban public health adaptation. We find that only 10% of the sampled urban areas report any public health adaptation initiatives. The initiatives identified most frequently address risks posed by extreme weather events and involve direct changes in management or behavior rather than capacity building, research, or long-term investments in infrastructure. Based on our characterization of the current urban health adaptation landscape, we identify several gaps: limited evidence of reporting of institutional adaptation at the municipal level in urban areas in the Global South; lack of information-based adaptation initiatives; limited focus on initiatives addressing infectious disease risks; and absence of monitoring, reporting, and evaluation. © The Author(s) 2015.

The Organizational Health of Urban Elementary Schools: School Health and Teacher Functioning.

PubMed

Mehta, Tara G; Atkins, Marc S; Frazier, Stacy L

2013-09-01

This study examined the factor structure of the Organizational Health Inventory-Elementary version (OHI-E; Hoy, Tarter, & Kottkamp, 1991) in a sample of 203 teachers working in 19 high-poverty, urban schools and the association of organizational school health with teacher efficacy, teacher stress, and job satisfaction. Results indicated a similar factor structure of the OHI-E as compared with the population of schools in the original sample (Hoy et al., 1991), and that specific components of organizational health, such as a positive learning environment, are associated with teacher efficacy, stress, and satisfaction. Overall, teachers' relations with their peers, their school leadership, and their students appear especially critical in high-poverty, urban schools. Recommendations for research and practice related to improving high-poverty, urban schools are presented.

The Organizational Health of Urban Elementary Schools: School Health and Teacher Functioning

PubMed Central

Mehta, Tara G.; Atkins, Marc S.; Frazier, Stacy L.

2013-01-01

This study examined the factor structure of the Organizational Health Inventory-Elementary version (OHI-E; Hoy, Tarter, & Kottkamp, 1991) in a sample of 203 teachers working in 19 high-poverty, urban schools and the association of organizational school health with teacher efficacy, teacher stress, and job satisfaction. Results indicated a similar factor structure of the OHI-E as compared with the population of schools in the original sample (Hoy et al., 1991), and that specific components of organizational health, such as a positive learning environment, are associated with teacher efficacy, stress, and satisfaction. Overall, teachers’ relations with their peers, their school leadership, and their students appear especially critical in high-poverty, urban schools. Recommendations for research and practice related to improving high-poverty, urban schools are presented. PMID:23935763

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana’s Community-based Health Planning and Services (CHPS)

PubMed Central

2014-01-01

Background Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. Methods This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. Results The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Conclusions Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings. PMID:24690310

Does the design and implementation of proven innovations for delivering basic primary health care services in rural communities fit the urban setting: the case of Ghana's Community-based Health Planning and Services (CHPS).

PubMed

Adongo, Philip Baba; Phillips, James F; Aikins, Moses; Arhin, Doris Afua; Schmitt, Margaret; Nwameme, Adanna U; Tabong, Philip Teg-Nefaah; Binka, Fred N

2014-04-01

Rapid urban population growth is of global concern as it is accompanied with several new health challenges. The urban poor who reside in informal settlements are more vulnerable to these health challenges. Lack of formal government public health facilities for the provision of health care is also a common phenomenon among communities inhabited by the urban poor. To help ameliorate this situation, an innovative urban primary health system was introduced in urban Ghana, based on the milestones model developed with the rural Community-Based Health Planning and Services (CHPS) system. This paper provides an overview of innovative experiences adapted while addressing these urban health issues, including the process of deriving constructive lessons needed to inform discourse on the design and implementation of the sustainable Community-Based Health Planning and Services (CHPS) model as a response to urban health challenges in Southern Ghana. This research was conducted during the six-month pilot of the urban CHPS programme in two selected areas acting as the intervention and control arms of the design. Daily routine data were collected based on milestones initially delineated for the rural CHPS model in the control communities whilst in the intervention communities, some modifications were made to the rural milestones. The findings from the implementation activities revealed that many of the best practices derived from the rural CHPS experiment could not be transplanted to poor urban settlements due to the unique organizational structures and epidemiological characteristics found in the urban context. For example, constructing Community Health Compounds and residential facilities within zones, a central component to the rural CHPS strategy, proved inappropriate for the urban sector. Night and weekend home visit schedules were initiated to better accommodate urban residents and increase coverage. The breadth of the disease burden of the urban residents also requires a broader expertise and training of the CHOs. Access to improved urban health services remains a challenge. However, current policy guidelines for the implementation of a primary health model based on rural experiences and experimental design requires careful review and modifications to meet the needs of the urban settings.

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

The Urban Forest Effects (UFORE) model: quantifying urban forest structure and functions

Treesearch

David J. Nowak; Daniel E. Crane

2000-01-01

The Urban Forest Effects (UFORE) computer model was developed to help managers and researchers quantify urban forest structure and functions. The model quantifies species composition and diversity, diameter distribution, tree density and health, leaf area, leaf biomass, and other structural characteristics; hourly volatile organic compound emissions (emissions that...

How community physical, structural, and social stressors relate to mental health in the urban slums of Accra, Ghana.

PubMed

Greif, Meredith J; Nii-Amoo Dodoo, F

2015-05-01

Urban health in developing counties is a major public health challenge. It has become increasingly evident that the dialog must expand to include mental health outcomes, and to shift focus to the facets of the urban environment that shape them. Population-based research is necessary, as empirical findings linking the urban environment and mental health have primarily derived from developed countries, and may not be generalizable to developing countries. Thus, the current study assesses the prevalence of mental health problems (i.e., depression, perceived powerlessness), as well as their community-based predictors (i.e., crime, disorder, poverty, poor sanitation, local social capital and cohesion), among a sample of 690 residents in three poor urban communities in Accra, Ghana. It uncovers that residents in poor urban communities in developing countries suffer from mental health problems as a result of local stressors, which include not only physical and structural factors but social ones. Social capital and social cohesion show complex, often unhealthy, relationships with mental health, suggesting considerable drawbacks in making social capital a key focus among policymakers. Copyright © 2015. Published by Elsevier Ltd.

Newborn healthcare in urban India

PubMed Central

Sharma, J; Osrin, D; Patil, B; Neogi, S B; Chauhan, M; Khanna, R; Kumar, R; Paul, V K; Zodpey, S

2016-01-01

The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood. PMID:27924107

Newborn healthcare in urban India.

PubMed

Sharma, J; Osrin, D; Patil, B; Neogi, S B; Chauhan, M; Khanna, R; Kumar, R; Paul, V K; Zodpey, S

2016-12-01

The rapid population growth in urban India has outpaced the municipal capacity to build essential infrastructures that make life in cities safe and healthy. Local and national governments alike are grappling with the challenges of urbanization with thousands migrating from villages to cities. Thus, urbanization in India has been accompanied by a concentration of poverty and urban public healthcare has emerged as one of the most pressing priorities facing our country. Newborn mortality rates in urban settings are lower than rural areas, early neonatal deaths account for greater proportion than late neonatal deaths. The available evidence suggests that socio-economic inequalities and poor environment pose major challenges for newborn health. Moreover, fragmented and weak public health system, multiplicity of actors and limited capacity of public health planning further constrain the delivery of quality and affordable health care service. Though healthcare is concentrated in urban areas, delay in deciding to seek health care, reaching a source of it and receiving appropriate care affects the health outcomes disproportionately. However, a few city initiatives and innovations piloted in different states and cities have brought forth the evidences of effectiveness of different strategies. Recently launched National Urban Health Mission (NUHM) provides an opportunity for strategic thinking and actions to improve newborn health outcomes in India. There is also an opportunity for coalescence of activities around National Health Mission (NHM) and Reproductive, Maternal, Newborn and Child Health+Adolescent (RMNCH+A) strategy to develop feasible and workable models in different urban settings. Concomitant operational research needs to be carried out so that the obstacles, approaches and response to the program can be understood.

Strategies for Disease Prevention and Health Promotion in Urban Areas: The Erice 50 Charter.

PubMed

D'Alessandro, D; Arletti, S; Azara, A; Buffoli, M; Capasso, L; Cappuccitti, A; Casuccio, A; Cecchini, A; Costa, G; De Martino, A M; Dettori, M; Di Rosa, E; Fara, G M; Ferrante, M; Giammanco, G; Lauria, A; Melis, G; Moscato, U; Oberti, I; Patrizio, C; Petronio, M G; Rebecchi, A; Romano Spica, V; Settimo, G; Signorelli, C; Capolongo, S

2017-01-01

The Erice 50 Charter titled "Strategies for Diseases Prevention and Health Promotion in Urban Areas" was unanimously approved at the conclusion of the 50th Residential Course "Urban Health. Instruments for promoting health and for assessing hygienic and sanitary conditions in urban areas", held from 29th March to 2nd April 2017 in Erice, at the "Ettore Majorana" Foundation and Centre for Scientific Culture and promoted by the International School of Epidemiology and Preventive Medicine "G. D'Alessandro" and the Study Group "Building Hygiene" of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI). At the conclusion of the intense learning experience during the Course, with more than 20 lectures, workshops and long-lasting discussions between Professors and Students, the participants identified the major points connecting urban features and Public Health, claiming the pivotal role of urban planning strategies for the management of Diseases Prevention and Health Promotion activities. The Erice 50 Charter is configured as a Decalogue for Healthy Cities and as a Think Tank for designing effective strategic actions and best practices to develop urban regeneration interventions and improve the urban quality of contemporary cities. The Decalogue is structured into the following key strategic objectives: 1. Promoting urban planning interventions that address citizens towards healthy behaviours; 2. Improving living conditions in the urban context; 3. Building an accessible and inclusive city, with a special focus on the frail population; 4. Encouraging the foundation of resilient urban areas; 5. Supporting the development of new economies and employment through urban renewal interventions; 6. Tackling social inequalities; 7. Improving stakeholders' awareness of the factors affecting Public Health in the cities; 8. Ensuring a participated urban governance; 9. Introducing qualitative and quantitative performance tools, capable of measuring the city's attitude to promote healthy lifestyles and to monitor the population's health status; 10. Encouraging sharing of knowledge and accessibility to informations. Finally, all the participants underlined that a multidisciplinary team, composed of Physicians specialized in Hygiene, Preventive Medicine, Public Health and Technicians as Architects, Urban planners and Engineers, is needed to deepen the research topic of Urban Health.

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.

'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.

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

Urban and non-urban differences in community living and participation among individuals with serious mental illnesses.

PubMed

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

2017-03-01

Despite a wealth of studies examining the relationship between urbanicity (i.e., living in an urban area) and psychological distress, there is a paucity of research examining the relationship between urbanicity, community living, and community participation of adults with serious mental illnesses. This study addresses this knowledge gap by assessing urban and non-urban differences in community participation, sense of community, mental health stigma, and perceptions of the neighborhood environment among individuals with serious mental illnesses living independently throughout the United States. A total of 300 individuals with serious mental illnesses recruited from 21 outpatient mental health service organizations in 15 states completed a phone survey about their community living and participation experiences. Urbanicity was examined at two spatial scales (block group and county), and independent-samples t-tests were employed to assess urban and non-urban differences in community living and participation variables. Levels of community participation and perceptions of neighborhood quality and crime were higher in urban block groups; sense of community was higher in urban counties; and perceptions of mental health stigma were higher in non-urban counties. Results inform the methodological literature on best practices for assessing urbanicity, as well as interventions aimed at increasing community participation and improving aspects of the built and social environment that affect individuals who experience mental health distress. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

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.

Toward improved public health outcomes from urban nature.

PubMed

Shanahan, Danielle F; Lin, Brenda B; Bush, Robert; Gaston, Kevin J; Dean, Julie H; Barber, Elizabeth; Fuller, Richard A

2015-03-01

There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities.

Toward Improved Public Health Outcomes From Urban Nature

PubMed Central

Bush, Robert; Gaston, Kevin J.; Dean, Julie H.; Barber, Elizabeth; Fuller, Richard A.

2015-01-01

There is mounting concern for the health of urban populations as cities expand at an unprecedented rate. Urban green spaces provide settings for a remarkable range of physical and mental health benefits, and pioneering health policy is recognizing nature as a cost-effective tool for planning healthy cities. Despite this, limited information on how specific elements of nature deliver health outcomes restricts its use for enhancing population health. We articulate a framework for identifying direct and indirect causal pathways through which nature delivers health benefits, and highlight current evidence. We see a need for a bold new research agenda founded on testing causality that transcends disciplinary boundaries between ecology and health. This will lead to cost-effective and tailored solutions that could enhance population health and reduce health inequalities. PMID:25602866

The Canadian Urban Environmental Health Research Consortium - a protocol for building a national environmental exposure data platform for integrated analyses of urban form and health.

PubMed

Brook, Jeffrey R; Setton, Eleanor M; Seed, Evan; Shooshtari, Mahdi; Doiron, Dany

2018-01-08

Multiple external environmental exposures related to residential location and urban form including, air pollutants, noise, greenness, and walkability have been linked to health impacts or benefits. The Canadian Urban Environmental Health Research Consortium (CANUE) was established to facilitate the linkage of extensive geospatial exposure data to existing Canadian cohorts and administrative health data holdings. We hypothesize that this linkage will enable investigators to test a variety of their own hypotheses related to the interdependent associations of built environment features with diverse health outcomes encompassed by the cohorts and administrative data. We developed a protocol for compiling measures of built environment features that quantify exposure; vary spatially on the urban and suburban scale; and can be modified through changes in policy or individual behaviour to benefit health. These measures fall into six domains: air quality, noise, greenness, weather/climate, and transportation and neighbourhood factors; and will be indexed to six-digit postal codes to facilitate merging with health databases. Initial efforts focus on existing data and include estimates of air pollutants, greenness, temperature extremes, and neighbourhood walkability and socioeconomic characteristics. Key gaps will be addressed for noise exposure, with a new national model being developed, and for transportation-related exposures, with detailed estimates of truck volumes and diesel emissions now underway in selected cities. Improvements to existing exposure estimates are planned, primarily by increasing temporal and/or spatial resolution given new satellite-based sensors and more detailed national air quality modelling. Novel metrics are also planned for walkability and food environments, green space access and function and life-long climate-related exposures based on local climate zones. Critical challenges exist, for example, the quantity and quality of input data to many of the models and metrics has changed over time, making it difficult to develop and validate historical exposures. CANUE represents a unique effort to coordinate and leverage substantial research investments and will enable a more focused effort on filling gaps in exposure information, improving the range of exposures quantified, their precision and mechanistic relevance to health. Epidemiological studies may be better able to explore the common theme of urban form and health in an integrated manner, ultimately contributing new knowledge informing policies that enhance healthy urban living.

Decomposing Mortality Disparities in Urban and Rural U.S. Counties.

PubMed

Spencer, Jennifer C; Wheeler, Stephanie B; Rotter, Jason S; Holmes, George M

2018-05-30

To understand the role of county characteristics in the growing divide between rural and urban mortality from 1980 to 2010. Age-adjusted mortality rates for all U.S. counties from 1980 to 2010 were obtained from the CDC Compressed Mortality File and combined with county characteristics from the U.S. Census Bureau, the Area Health Resources File, and the Inter-University Consortium for Political and Social research. We used Oaxaca-Blinder decomposition to assess the extent to which rural-urban mortality disparities are explained by observed county characteristics at each decade. Decomposition shows that, at each decade, differences in rural/urban characteristics are sufficient to explain differences in mortality. Furthermore, starting in 1990, rural counties have significantly lower predicted mortality than urban counties when given identical county characteristics. We find changes in the effect of characteristics on mortality, not the characteristics themselves, drive the growing mortality divide. Differences in economic and demographic characteristics between rural and urban counties largely explain the differences in age-adjusted mortality in any given year. Over time, the role these characteristics play in improving mortality has increased differentially for urban counties. As characteristics continue changing in importance as determinants of health, this divide may continue to widen. © Health Research and Educational Trust.

Exploring complex causal pathways between urban renewal, health and health inequality using a theory-driven realist approach.

PubMed

Mehdipanah, Roshanak; Manzano, Ana; Borrell, Carme; Malmusi, Davide; Rodriguez-Sanz, Maica; Greenhalgh, Joanne; Muntaner, Carles; Pawson, Ray

2015-01-01

Urban populations are growing and to accommodate these numbers, cities are becoming more involved in urban renewal programs to improve the physical, social and economic conditions in different areas. This paper explores some of the complexities surrounding the link between urban renewal, health and health inequalities using a theory-driven approach. We focus on an urban renewal initiative implemented in Barcelona, the Neighbourhoods Law, targeting Barcelona's (Spain) most deprived neighbourhoods. We present evidence from two studies on the health evaluation of the Neighbourhoods Law, while drawing from recent urban renewal literature, to follow a four-step process to develop a program theory. We then use two specific urban renewal interventions, the construction of a large central plaza and the repair of streets and sidewalks, to further examine this link. In order for urban renewal programs to affect health and health inequality, neighbours must use and adapt to the changes produced by the intervention. However, there exist barriers that can result in negative outcomes including factors such as accessibility, safety and security. This paper provides a different perspective to the field that is largely dominated by traditional quantitative studies that are not always able to address the complexities such interventions provide. Furthermore, the framework and discussions serve as a guide for future research, policy development and evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

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

The Role of Gender Empowerment on Reproductive Health Outcomes in Urban Nigeria

PubMed Central

Speizer, Ilene S.; Fotso, Jean-Christophe; Akiode, Akinsewa; Saad, Abdulmumin; Calhoun, Lisa; Irani, Laili

2014-01-01

Objectives To date, limited evidence is available for urban populations in sub-Saharan Africa, specifically research into the association between urban women’s empowerment and reproductive health outcomes. The objective of this study is to investigate whether women’s empowerment in urban Nigerian settings is associated with family planning use and maternal health behaviors. Moreover, we examine whether different effects of empowerment exist by region of residence. Methods This study uses baseline household survey data from the Measurement, Learning & Evaluation Project (MLE) for the Nigerian Urban Reproductive Health Initiative (NURHI) being implemented in six major cities. We examine four dimensions of empowerment: economic freedom, attitudes towards domestic violence, partner prohibitions and decision-making. We determine if the empowerment dimensions have different effects on reproductive health outcomes by region of residence using multivariate analyses. Results Results indicate that more empowered women are more likely to use modern contraception, deliver in a health facility and have a skilled attendant at birth. These trends vary by empowerment dimension and by city/region in Nigeria. Conclusions We conclude by discussing the implications of these findings on future programs seeking to improve reproductive health outcomes in urban Nigeria and beyond. PMID:23576403

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

EPA'S URBAN RESEARCH PROGRAM IN BMPS AND RESTORATION FOR WATER QUALITY IMPROVEMENT

EPA Science Inventory

The Urban Watershed Management Branch is responsible for developing, and demonstrating technologies and methods required to manage the risk to public health, property and the environment from wet weather flows (WWF) in urban watersheds. The activities are primarily aimed at rest...

EPA'S URBAN RESEARCH PROGRAM IN BMPS AND RESTORATION FOR WATER QUALITY IMPROVEMENT

EPA Science Inventory

The Urban Watershed Management Branch is responsible for developing, and demonstrating technologies and methods required to managing the risk to public health, property and the environment from wet weather flows (WWF) in urban watersheds. The activities are primarily aimed at re...

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.

'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.

Overview on urban and peri-urban agriculture: definition, impact on human health, constraints and policy issues.

PubMed

Kang'ethe, E K; Grace, D; Randolph, T F

2007-11-01

To collate and synthesize current knowledge of components of urban agriculture (UA) with a thematic emphasis on human health impact and a geographic emphasis on East Africa. Data management followed a structured approach in which key issues were first identified and then studies selected through literature search and personal communication. Evidence-based principles. Urban agriculture is an important source of food security for urban dwellers in East Africa. Descriptors of UA are location, areas, activities, scale, products, destinations, stakeholders and motivation. Many zoonotic and food-borne diseases have been associated with UA but evidence on human health impact and management is lacking. Major constraints to UA are illegality and lack of access to input and market; policy options have been developed for overcoming these. Urban agriculture is an important activity and likely to remain so. Both positive and negative human health impacts are potentially important but more research is needed to understand these and set appropriate policy and support levels.

Metro nature, environmental health, and economic value.

PubMed

Wolf, Kathleen L; Robbins, Alicia S T

2015-05-01

Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements-collectively termed metro nature-generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits.

The impact of residential status on cognitive decline among older adults in China: Results from a longitudinal study.

PubMed

Xu, Hanzhang; Dupre, Matthew E; Gu, Danan; Wu, Bei

2017-05-15

Residential status has been linked to numerous determinants of health and well-being. However, the influence of residential status on cognitive decline remains unclear. The purpose of this research was to assess the changes of cognitive function among older adults with different residential status (urban residents, rural-to-urban residents, rural residents, and urban-to-rural residents), over a 12-year period. We used five waves of data (2002, 2005, 2008/2009, 2011/2012, and 2014) from the Chinese Longitudinal Healthy Longevity Survey with 17,333 older adults age 65 and over who were interviewed up to five times. Cognitive function was measured by the Mini Mental State Examination (MMSE). Multilevel models were used regarding the effects of residential status after adjusting for demographic characteristics, socioeconomic factors, family support, health behaviors, and health status. After controlling for covariates, significant differences in cognitive function were found across the four groups: rural-to-urban and rural residents had a higher level of cognition than urban residents at baseline. On average, cognitive function decreased over the course of the study period. Rural-to-urban and rural residents demonstrated a faster decline in cognitive function than urban residents. This study suggests that residential status has an impact on the rate of changes in cognition among older adults in China. Results from this study provide directions for future research that addresses health disparities, particularly in countries that are undergoing significant socioeconomic transitions.

Governance and networks for health co-benefits of climate change mitigation: Lessons from two Indian cities.

PubMed

Puppim de Oliveira, Jose A; Doll, Christopher N H

2016-12-01

Health has been the main driver for many urban environmental interventions, particularly in cases of significant health problems linked to poor urban environmental conditions. This paper examines empirically the links between climate change mitigation and health in urban areas, when health is the main driver for improvements. The paper aims to understand how systems of urban governance can enable or prevent the creation of health outcomes via continuous improvements in the environmental conditions in a city. The research draws on cases from two Indian cities where initiatives were undertaken in different sectors: Surat (waste) and Delhi (transportation). Using the literature on network effectiveness as an analytical framework, the paper compares the cases to identify the possible ways to strengthen the governance and policy making process in the urban system so that each intervention can intentionally realize multiple impacts for both local health and climate change mitigation in the long term as well as factors that may pose a threat to long-term progress and revert back to the previous situation after initial achievements. Copyright © 2016 Elsevier Ltd. All rights reserved.

Gender Differences in the Longitudinal Impact of Exposure to Violence on Mental Health in Urban Youth

ERIC Educational Resources Information Center

Zona, Kate; Milan, Stephanie

2011-01-01

There is evidence of gender differences in psychopathology during adolescence, but little research has investigated gender differences in trauma-related symptoms. Exposure to violence is a commonly experienced potentially traumatic event among urban adolescents, and the few studies examining gender differences in its mental health impact have…

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.

Urban college student self-report of hookah use with health care providers.

PubMed

Jani, Samir Ranjit; Brown, Darryl; Berhane, Zekarias; Peter, Nadja; Solecki, Susan; Turchi, Renee

2018-07-01

This study's purpose was to describe urban college students' communication about hookah with health care providers. Participants included a random sample of undergraduate urban college students and health care providers. Students surveyed determined the epidemiology of hookah use in this population, how many health care providers asked about hookah, and how many students admitted hookah use to a physician. Of 375 students surveyed, 78 (20.8%) had never tried it, 284 (75.7%) had smoked hookah at least once, and 64 students (22.6%) were classified as frequent hookah smokers. Only 15 (4.7%) reported a health care provider asking about hookah during visits, whereas 36 (12.7%) admitted their hookah use to a health care provider. Hookah use was found to be highly prevalent among students in one urban university. This study supports the hypothesis that few health care providers broach the topic with patients. Additional research on health consequences of hookah use, education, and improved screening is warranted.

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-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.

Health-Related Quality of Life of Low-Socioeconomic-Status Populations in Urban China.

PubMed

Wu, Lei; Zhang, Huiping

2016-11-20

Previous researchers had not yet examined the association between socioeconomic status (SES) and health-related quality of life (HRQOL) in urban China. The present study attempts to assess HRQOL of lower-SES populations in urban China in comparison with middle- and high-SES populations, and then to examine the mediating role of sense of control between SES and HRQOL. A national representative sample of 1,856 participants responded to the HRQOL survey using the 12-item Short Form Health Survey (SF-12), conducted by the Chinese General Social Survey research team in 2010. The results showed that lower-SES populations reported lower HRQOL than middle- and high-SES populations. Sense of control could partially mediate the association between social class and HRQOL. These findings will generate significant policy and practice implications for identifying those at particular risk for lower HRQOL and, accordingly, suggesting ways to improve their HRQOL through specific social work interventions in urban China's context. © 2016 National Association of Social Workers.

The concentration of disadvantage and the rise of an urban penalty: urban slum prevalence and the social production of health inequalities in the developing countries.

PubMed

Rice, James; Rice, Julie Steinkopf

2009-01-01

Urban slums are proliferating in the developing countries. A corollary of this structural transformation is the increasing recognition of an urban penalty wherein slum populations exhibit notable inequalities in health relative to non-slum urban residents and even rural populations. The built urban environment, in turn, is a crucial context within which the social production of disproportionate morbidity and mortality is enacted. The authors develop this assertion and use bivariate and partial correlation analysis to highlight the association of urban slum prevalence, or proportion of the total population living in urban slum conditions, with indicators of mortality and gender parity, measured at the national level. Data for 99 developing countries show that greater urban slum prevalence is strongly correlated with higher levels of infant, child, and maternal mortality. Further, urban slum prevalence exhibits strong, deleterious correlations with gender parity (measured by the gender development index) and fertility rate, factors that have a crucial direct impact in shaping variant mortality levels. Future research is warranted on the social inequalities in health and illness derived from the expansion of urban slum conditions in the developing countries.

Factors influencing indoor air quality in an urban high rise apartment building (retitled as "Air Pollution and air exchange in an urban high rise apartment building")

EPA Science Inventory

The National Exposure Research Laboratory (NERL) Human Exposure and Atmospheric Sciences Division (HEASD) conducts research in support of EPA mission to protect human health and the environment. HEASD research program supports Goal 1 (Clean Air) and Goal 4 (Healthy People) of EP...

U.S. EPA'S URBAN WATERSHED RESEARCH PROGRAM IN BMPS AND RESTORATION FOR WATER QUALITY MANAGEMENT

EPA Science Inventory

The U.S. EPA's Urban Watershed Management Branch is responsible for developing and demonstrating technologies and methods required managing the risk to public health, property and the environment from wet weather flows (WWF) in urban watersheds. The activities are primarily aimed...

Fine-Scale Environmental Indicators of Public Health and Well ...

EPA Pesticide Factsheets

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, EPA and its research partners have identified urban environmental features that have been linked in the scientific literature to specific aspects of public health and well-being. Examples of these features include tree cover along walkable roads, overall neighborhood green space, green window views, and proximity to parks. Associated aspects of health and well-being include physical fitness, social capital, school performance, and longevity. In many previous studies, stronger associations were observed in disproportionately vulnerable populations such as children, the elderly, and those of lower socioeconomic status.EnviroAtlas researchers have estimated and mapped a suite of urban environmental features by synthesizing newly-generated one-meter resolution landcover data, downscaled census population data, and existing datasets such as roads and waterways. Resulting geospatial metrics represent health-related indicators of urban ecosystem services supply and demand at the census block-group and finer. They have been developed using consistent methods to facilitate comparisons between neighborhoods and across multiple U.S. communities. Demographic overlays, also available in EnviroAtl

Brothers, Sisters and Fictive Kin: Communication about Sex among Urban Black Siblings

ERIC Educational Resources Information Center

Wallace, Scyatta A.; Hooper, Lisa M.; Persad, Malini

2014-01-01

Siblings have been shown to influence youth substance use and violent behavior. However, limited research has examined sibling-influences on sexual activity, particularly among urban Black youth. The current qualitative research was an exploratory study to describe discussions among siblings about sex and sexual health. Individual interviews were…

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…

Creating and validating GIS measures of urban design for health research.

PubMed

Purciel, Marnie; Neckerman, Kathryn M; Lovasi, Gina S; Quinn, James W; Weiss, Christopher; Bader, Michael D M; Ewing, Reid; Rundle, Andrew

2009-12-01

Studies relating urban design to health have been impeded by the unfeasibility of conducting field observations across large areas and the lack of validated objective measures of urban design. This study describes measures for five dimensions of urban design - imageability, enclosure, human scale, transparency, and complexity - created using public geographic information systems (GIS) data from the US Census and city and state government. GIS measures were validated for a sample of 588 New York City block faces using a well-documented field observation protocol. Correlations between GIS and observed measures ranged from 0.28 to 0.89. Results show valid urban design measures can be constructed from digital sources.

Creating and validating GIS measures of urban design for health research

PubMed Central

Purciel, Marnie; Neckerman, Kathryn M.; Lovasi, Gina S.; Quinn, James W.; Weiss, Christopher; Bader, Michael D.M.; Ewing, Reid; Rundle, Andrew

2012-01-01

Studies relating urban design to health have been impeded by the unfeasibility of conducting field observations across large areas and the lack of validated objective measures of urban design. This study describes measures for five dimensions of urban design – imageability, enclosure, human scale, transparency, and complexity – created using public geographic information systems (GIS) data from the US Census and city and state government. GIS measures were validated for a sample of 588 New York City block faces using a well-documented field observation protocol. Correlations between GIS and observed measures ranged from 0.28 to 0.89. Results show valid urban design measures can be constructed from digital sources. PMID:22956856

Nutritional status and its health-related factors among older adults in rural and urban areas.

PubMed

Chen, Su-Hui; Cheng, Hsin-Yi; Chuang, Yeu-Hui; Shao, Jung-Hua

2015-01-01

To compare health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban counties of Taiwan. The older adult population of Taiwan is increasing. Furthermore, older people living in rural areas have shorter life expectancy and more chronic diseases than their urban counterparts. However, little is known about the health-related characteristics, nutrition-related factors and nutritional status of older adults living in rural and urban areas of Taiwan, limiting nurses' ability to identify and care for older adults at risk of poor nutritional health. Cross-sectional, comparative. Older adults were randomly selected from names of residents of an adjacent rural and urban area of northern Taiwan and having completing the 2009 health evaluation. From March-July 2010, older adult participants (N = 366) provided data on demographic and health-related information, nutritional self-efficacy, health locus of control and nutritional status. Data were analysed by descriptive statistics and compared using chi-square and t-test. Older rural participants had significantly lower educational level, less adequate income, higher medication use, lower scores on self-rated health status and researcher-rated health status and lower self-rated healthy eating status than their urban counterparts. Moreover, rural participants had significantly lower nutritional self-efficacy, higher chance health locus of control and poorer nutritional status than their urban counterparts. Our results suggest that nurses should assess older adults living in rural areas for nutritional health and nutrition knowledge. Based on this assessment, nurses should develop easy, practical and accessible nutritional programmes for this population. © 2014 John Wiley & Sons Ltd.

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.

Toward a Socio-Territorial Approach to Health: Health Equity in West Africa.

PubMed

Vialard, Lucie; Squiban, Clara; Fournet, Florence; Salem, Gérard; Foley, Ellen E

2017-01-22

This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings.

Toward a Socio-Territorial Approach to Health: Health Equity in West Africa

PubMed Central

Vialard, Lucie; Squiban, Clara; Fournet, Florence; Salem, Gérard; Foley, Ellen E.

2017-01-01

This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings. PMID:28117751

Metro Nature, Environmental Health, and Economic Value

PubMed Central

Robbins, Alicia S.T.

2015-01-01

Background Nearly 40 years of research provides an extensive body of evidence about human health, well-being, and improved function benefits associated with experiences of nearby nature in cities. Objectives We demonstrate the numerous opportunities for future research efforts that link metro nature, human health and well-being outcomes, and economic values. Methods We reviewed the literature on urban nature-based health and well-being benefits. In this review, we provide a classification schematic and propose potential economic values associated with metro nature services. Discussion Economic valuation of benefits derived from urban green systems has largely been undertaken in the fields of environmental and natural resource economics, but studies have not typically addressed health outcomes. Urban trees, parks, gardens, open spaces, and other nearby nature elements—collectively termed metro nature—generate many positive externalities that have been largely overlooked in urban economics and policy. Here, we present a range of health benefits, including benefit context and beneficiaries. Although the understanding of these benefits is not yet consistently expressed, and although it is likely that attempts to link urban ecosystem services and economic values will not include all expressions of cultural or social value, the development of new interdisciplinary approaches that integrate environmental health and economic disciplines are greatly needed. Conclusions Metro nature provides diverse and substantial benefits to human populations in cities. In this review, we begin to address the need for development of valuation methodologies and new approaches to understanding the potential economic outcomes of these benefits. Citation Wolf KL, Robbins AS. 2015. Metro nature, environmental health, and economic value. Environ Health Perspect 123:390–398; http://dx.doi.org/10.1289/ehp.1408216 PMID:25626137

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.

European Healthy City Network Phase V: patterns emerging for healthy urban planning.

PubMed

Grant, Marcus

2015-06-01

There is a tradition of planning cities and their infrastructure to successfully tackle communicable disease arising from urban development. Non-communicable disease follows a different course. Development brings in its wake a basket of adverse health and health equity outcomes that are proving difficult to tackle. In response, within Phase V of the European Healthy Cities Network, municipalities have implemented a range of policy and physical interventions using a settings approach. Owing to the time lag between physical interventions and health outcomes, this research interrogates city activity itself to develop better understanding. Self-reported city case studies and questionnaire data were analysed to reveal patterns using an inductive approach. Findings indicate that some categories of intervention, such as whole city planning and transport, have a systemic impact across the wider determinants of health. Addressing transferability and stakeholder understanding helped cities create conditions for successful outcomes. Cities had varying urban development approaches for tackling climate change. Improvements to current practice are discussed, including; a distinction between supply side and demand side in healthy urban planning; valuing co-benefits and developing integrative approaches to the evidence-base. This evaluative article is important for cities wanting to learn how to maximize benefits to public health through urban development and for researchers exploring, with a systemic approach, the experiences of European cities acting at the interface of urban development and public health. This article also provides recommendations for future phases of the WHO European Healthy Cities programme, posing questions to better address governance and equity in spatial planning. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

[Healthy Cities projects].

PubMed

Takano, Takehito

2002-05-01

This is a review article on "Healthy Cities". The Healthy Cities programme has been developed by the World Health Organization (WHO) to tackle urban health and environmental issues in a broad way. It is a kind of comprehensive policy package to carry out individual projects and activities effectively and efficiently. Its key aspects include healthy public policy, vision sharing, high political commitment, establishment of structural organization, strategic health planning, intersectoral collaboration, community participation, setting approach, development of supportive environment for health, formation of city health profile, national and international networking, participatory research, periodic monitoring and evaluation, and mechanisms for sustainability of projects. The present paper covered the Healthy Cities concept and approaches, rapid urbanization in the world, developments of WHO Healthy Cities, Healthy Cities developments in the Western Pacific Region, the health promotion viewpoint, and roles of research.

Lessons Learned Recruiting Minority Participants for Research in Urban Community Health Centers.

PubMed

Fam, Elizabeth; Ferrante, Jeanne M

2018-02-01

To help understand and mitigate health disparities, it is important to conduct research with underserved and underrepresented minority populations under real world settings. There is a gap in the literature detailing real-time research staff experience, particularly in their own words, while conducting in-person patient recruitment in urban community health centers. This paper describes challenges faced at the clinic, staff, and patient levels, our lessons learned, and strategies implemented by research staff while recruiting predominantly low-income African-American women for an interviewer-administered survey study in four urban Federally Qualified Health Centers in New Jersey. Using a series of immersion-crystallization cycles, fieldnotes and research reflections written by recruiters, along with notes from team meetings during the study, were qualitatively analyzed. Clinic level barriers included: physical layout of clinic, very low or high patient census, limited private space, and long wait times for patients. Staff level barriers included: unengaged staff, overburdened staff, and provider and staff turnover. Patient level barriers included: disinterested patients, patient mistrust and concerns over confidentiality, no-shows or lack of patient time, and language barrier. We describe strategies used to overcome these barriers and provide recommendations for in-person recruitment of underserved populations into research studies. To help mitigate health disparities, disseminating recruiters' experiences, challenges, and effective strategies used will allow other researchers to build upon these experience in order to increase recruitment success of underserved and underrepresented minority populations into research studies. Copyright © 2018 National Medical Association. Published by Elsevier Inc. All rights reserved.

The Effect of Racial Socialization on Urban African American Use of Child Mental Health Services

PubMed Central

Cavaleri, Mary A.; Rodriguez, James; McKay, Mary M.

2009-01-01

SUMMARY Objective To examine how parental endorsement of racial socialization parenting practices relates to child mental health service use among an urban sample of African American families. Methods A cross-sectional sample of urban African American parents (n = 96) provided ratings of their beliefs concerning various dimensions of racial socialization constructs, i.e., spiritual or religious coping (SRC), extended family caring (EFC), cultural pride reinforcement (CPR), and assessed regarding their use of child mental health services. Results At the multivariate level, the use of child mental health services was significantly positively associated with moderate levels of endorsement of SRC and EFC. Inversely, scores in the moderate range of CPR were associated with a reduced likelihood of child mental health service use. Conclusion Parental endorsement of racial socialization parenting practices appear to play a salient role in child mental health service use among an urban African American families. Further research with larger and more representative samples should be pursued. PMID:20228964

The Role of Ecology in Public Health: Research and Educational Opportunities Using EnviroAtlas

EPA Science Inventory

A growing area of public-health research and practice concerns the relationships between physical and visual access to urban green space, and stress, physical fitness, cognitive function and other aspects of health and wellness. Natural features can modify adverse effects of nois...

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…

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…

Community medicine in action: an integrated, fourth-year urban continuity preceptorship.

PubMed

Brill, John R; Jackson, Thomas C; Stearns, Marjorie A

2002-07-01

To provide an opportunity for fourth-year students at the University of Wisconsin Medical School in Madison to immerse in urban community medicine during a 34-week program. This experience enhances the integrity of the fourth year as well as merges medicine and public health perspectives in medical education as called for by the Medicine and Public Health Initiative. A limited number of fourth-year Wisconsin medical students have the opportunity to select a one-year, continuity-based preceptorship at the Milwaukee clinical campus with a focus in one of three domains: family medicine, internal medicine, or women's health. Students participate in the following clinical activities: a one-year, integrated preceptorship (one to three half days per week in a primary preceptor's office), medicine subinternship, senior surgery clerkship, selectives (16-20 weeks of clerkships relevant to preceptorship focus area), and one month of out-of-city electives. Complementing this community-based clinical experience is the opportunity to develop an increased appreciation for urban community health issues and resources by participating in a required urban community medicine clerkship and a mentored student scholarly project focusing on an aspect of urban community medicine and population health. All students begin the year in July with a four-week urban community medicine clerkship, which is based on the St. Luke's family practice residency's community medicine rotation and arranged by residency faculty. They conduct a "windshield survey" of a Milwaukee neighborhood, observing health hazards and identifying assets, and then present these observations to others in the clerkship. During this first month, students are introduced to the work of a variety of social service agencies, the Milwaukee City Health Department, and the Aurora Health Care/UW community clinics, which serve the state's most diverse zip codes. They meet with providers and researchers who share their expertise in infectious disease, preventive medicine, perinatal epidemiology, domestic violence, sexual assault, and disease management. Students develop increased understanding of barriers to health and personal resilience by listening to focus groups conducted with homeless men and undocumented Latino women. They participate in a resident and faculty development retreat on enhancing community medicine knowledge and skills. By August, students select an advisor and outline a project designed to expand understanding in the areas of urban population health research, community health education, professional education, or health intervention planning and evaluation. Faculty members at the Center for Urban Population Health work closely with the students throughout the year, which includes two weeks in the spring that are dedicated to intensive work on the projects. This fourth-year, urban community-based preceptorship is designed to provide students with an alternative fourth year that integrates skill development in clinical and community medicine, offers a continuity primary care experience, and showcases innovative urban health resources and role models. It is hoped that these students will pursue graduate medical education in Milwaukee, incorporate a population perspective in their practice, and choose to work in neighborhoods that are currently underserved.

Bouncers, brokers, and glue: the self-described roles of social workers in urban hospitals.

PubMed

Craig, Shelley L; Muskat, Barbara

2013-02-01

Social workers delivering services in health care settings face unique challenges and opportunities. The purpose of this study was to solicit input from social workers employed in urban hospitals about their perceptions of the roles, contribution, and professional functioning of social work in a rapidly changing health care environment. Using qualitative methods, the university and hospital-based research team conducted seven focus groups (n = 65) at urban hospitals and analyzed the data using an interpretive framework with ATLAS.ti software. Seven major themes emerged from the participants' description of their roles: bouncer, janitor, glue, broker, firefighter, juggler, and challenger. Along with descriptions of the ways social workers fulfilled those roles, participants articulated differences in status within those roles, the increasing complexity of discharge planning, and expectations to provide secondary support to other health care professionals on their teams. Implications for practice and research are discussed.

Yaitya tirka madlanna warratinna: exploring what sexual health nurses need to know and do in order to meet the sexual health needs of young Aboriginal women in Adelaide.

PubMed

Kelly, Janet; Luxford, Yoni

2007-07-01

Young Aboriginal women are consistently identified as having poorer health outcomes and access to sexual health services than non-Indigenous Australians. Yet the literature is particularly silent on what sexual health nurses need to know and do in order to work well with young urban Aboriginal women. This paper reports on a qualitative pilot study undertaken by a non-Indigenous nurse in Adelaide. The participatory action research methods used in this study were sensitive to the history of problems associated with research in Aboriginal communities. A reference group of Elder Aboriginal women and Aboriginal health workers guided all aspects of the study. A partnership approach between the researcher and the Reference Group ensured that the methods, analysis, and final report were culturally safe. Three groups participated in this study: Elders and Aboriginal health workers; young Aboriginal women, and sexual health nurses. All participants acknowledged the importance of nurses being clinically competent. However, the overarching finding was a lack of a clear model of cultural care to guide health service delivery. Three interrelated themes emerged from the data to support this contention. These were: the structural and personal importance of establishing and maintaining trustworthy relationships between nurses, Aboriginal health workers and Elders; the recognition that Aboriginal culture does exist, and is important in urban areas; and the importance of gender considerations to understanding urban women's health business. A partnership approach was recommended as a way to use these findings to develop a transparent cultural model of care. Further research is currently being undertaken to progress this agenda.

Urbanization and health in developing countries.

PubMed

Harpham, T; Stephens, C

1991-01-01

In developing countries the level of urbanization is expected to increase to 39.5% by the end of this century and to 56.9% by 2025. The number of people living in slums and shanty towns represent about one-third of the people living in cities in developing countries. This article focuses upon these poor urban populations and comments upon their lifestyle and their exposure to hazardous environmental conditions which are associated with particular patterns of morbidity and mortality. The concept of marginality has been used to describe the lifestyle of the urban poor in developing countries. This concept is critically examined and it is argued that any concept of the urban poor in developing countries being socially, economically or politically marginal is a myth. However, it can certainly be claimed that in health terms the urban poor are marginal as demonstrated by some of the studies reviewed in this article. Most studies of the health of the urban poor in developing countries concentrate on the environmental conditions in which they live. The environmental conditions of the urban poor are one of the main hazards of the lifestyle of poor urban residents. However, other aspects of their way of life, or lifestyle, have implications for their health. Issues such as smoking, diet, alcohol and drug abuse, and exposure to occupational hazards, have received much less attention in the literature and there is an urgent need for more research in these areas.

Residential mobility and trajectories of adiposity among adolescents in urban and non-urban neighborhoods.

PubMed

Jones, Antwan

2015-04-01

Using data from the 1994-2008 National Longitudinal Study of Adult Health (Add Health), this research examines the relationship between residential mobility and weight gain over time among urban and non-urban young adults. It is theorized that changes in residence act as a barrier to achieving an active lifestyle, which would increase an individual's body mass index (BMI) over time. Relying on linear mixed-effects growth curve models, the results indicate that mobility is protective against weight gain over time after controlling for sociodemographic characteristics. For young adults who are residentially stable in urban neighborhoods, increases in physical activity are associated with a linear decline in BMI. In non-urban areas where respondents are residentially mobile, body weight does not fluctuate as sedentary behavior increases. However, in those areas, weight increases as sedentary behavior increases for those who did not move. Overall, the results suggest that the effect of mobility on weight gain is partially due to the kind of health behaviors that one engages in as well as whether or not one lives in an urban area. Policies geared toward relocating residents (such as Moving to Opportunity), and neighborhood processes that can lead individuals to change residences (such as foreclosures or gentrification) may have adverse health effects depending on whether they are occurring in urban or non-urban areas.

Health impact assessment on urban development projects in France: finding pathways to fit practice to context.

PubMed

Roué-Le Gall, Anne; Jabot, Françoise

2017-06-01

In France, there is increasing interest in health impact assessments (HIAs) and most are performed on urban projects. The field of expertise is still under development and mostly established within the public health sector. To date, in France, all HIAs conducted in urban planning are stand-alone HIAs disconnected from the required environmental impact assessment (EIA). The paper opens with an introduction of the close and complex relationship between health and urban planning, HIA and a description of key elements needed for understanding the French context. Then, the paper analyses the context and the implementation process for four HIAs in progress in order to understand the specific characteristics of urban development, identify the key stages for introducing a health perspective into urban projects, and extract avenues to be explored when adapting HIAs applied to urban planning in France. Using a qualitative multiple case study design, an analysis framework was built to compare several aspects of the four HIAs and made it possible to highlight three pathways for adapting HIA to the urban planning sector: the schedule, links between the EIA and HIA, and the complementarity of the initiatives to involve residents. Legal measures enable a point of contact that brings health institutions and cities closer together. HIA is yet another tool that public authorities now have at their fingertips to work together in strengthening democracy and in reducing social, geographical and environmental health inequalities. More research must be undertaken to develop an understanding of the practice-related context; to judge HIA's capacity to draw on existing approaches in different fields; and to explore the different avenues leading to increased health, wellbeing and equity.

A comparison of health inequalities in urban and rural Scotland.

PubMed

Levin, Kate A; Leyland, Alastair H

2006-03-01

Previous research suggests that there are significant differences in health between urban and rural areas. Health inequalities between the deprived and affluent in Scotland have been rising over time. The aim of this study was to examine health inequalities between deprived and affluent areas of Scotland for differing ruralities and look at how these have changed over time. Postcode sectors in Scotland were ranked by deprivation and the 20% most affluent and 20% most deprived areas were found using the Carstairs indicator and male unemployment. Scotland was then split into 4 rurality types. Ratios of health status between the most deprived and most affluent areas were investigated using all cause mortality for the Scottish population, 1979-2001. These were calculated over time for 1979-1983, 1989-1993, 1998-2001. Multilevel Poisson modelling was carried out for all of Scotland excluding Grampian to assess inequalities in the population. There was an increase in inequalities between 1981 and 2001, which was greatest in remote rural Scotland for both males and females; however, male health inequalities remained higher in urban areas throughout this period. In 2001 female health inequalities were higher in remote rural areas than urban areas. Health inequalities amongst the elderly (age 65+) in 2001 were greater in remote rural Scotland than urban areas for both males and females.

Designing Green Stormwater Infrastructure for Hydrologic and Human Benefits: An Image Based Machine Learning Approach

NASA Astrophysics Data System (ADS)

Rai, A.; Minsker, B. S.

2014-12-01

Urbanization over the last century has degraded our natural water resources by increasing storm-water runoff, reducing nutrient retention, and creating poor ecosystem health downstream. The loss of tree canopy and expansion of impervious area and storm sewer systems have significantly decreased infiltration and evapotranspiration, increased stream-flow velocities, and increased flood risk. These problems have brought increasing attention to catchment-wide implementation of green infrastructure (e.g., decentralized green storm water management practices such as bioswales, rain gardens, permeable pavements, tree box filters, cisterns, urban wetlands, urban forests, stream buffers, and green roofs) to replace or supplement conventional storm water management practices and create more sustainable urban water systems. Current green infrastructure (GI) practice aims at mitigating the negative effects of urbanization by restoring pre-development hydrology and ultimately addressing water quality issues at an urban catchment scale. The benefits of green infrastructure extend well beyond local storm water management, as urban green spaces are also major contributors to human health. Considerable research in the psychological sciences have shown significant human health benefits from appropriately designed green spaces, yet impacts on human wellbeing have not yet been formally considered in GI design frameworks. This research is developing a novel computational green infrastructure (GI) design framework that integrates hydrologic requirements with criteria for human wellbeing. A supervised machine learning model is created to identify specific patterns in urban green spaces that promote human wellbeing; the model is linked to RHESSYS model to evaluate GI designs in terms of both hydrologic and human health benefits. An application of the models to Dead Run Watershed in Baltimore showed that image mining methods were able to capture key elements of human preferences that could improve tree-based GI design. Hydrologic benefits associated with these features were substantial, indicating that increased urban tree coverage and a more integrated GI design approach can significantly increase both human and hydrologic benefits.

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.

Social determinants in an Australian urban region: a 'complexity' lens.

PubMed

Fisher, Matthew; Milos, Danijela; Baum, Frances; Friel, Sharon

2016-03-01

Area-based strategies have been widely employed in efforts to improve population health and take action on social determinants of health (SDH) and health inequities, including in urban areas where many of the social, economic and environmental factors converge to influence health. Increasingly, these factors are recognized as being part of a complex system, where population health outcomes are shaped by multiple, interacting factors operating at different levels of social organization. This article reports on research to assess the extent to which an alliance of health and human service networks is able to promote action on SDH within an Australian urban region, using a complex systems frame. We found that such an alliance was able to promote some effective action which takes into account complex interactions between social factors affecting health, but also identified significant potential barriers to other forms of desired action identified by alliance members. We found that a complex systems lens was useful in assessing a collaborative intervention to address SDH within an urban region. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Nature-Based Strategies for Improving Urban Health and Safety.

PubMed

Kondo, Michelle C; South, Eugenia C; Branas, Charles C

2015-10-01

Place-based programs are being noticed as key opportunities to prevent disease and promote public health and safety for populations at-large. As one key type of place-based intervention, nature-based and green space strategies can play an especially large role in improving health and safety for dwellers in urban environments such as US legacy cities that lack nature and greenery. In this paper, we describe the current understanding of place-based influences on public health and safety. We focus on nonchemical environmental factors, many of which are related to urban abandonment and blight. We then review findings from studies of nature-based interventions regarding impacts on health, perceptions of safety, and crime. Based on our findings, we suggest that further research in this area will require (1) refined measures of green space, nature, and health and safety for cities, (2) interdisciplinary science and cross-sector policy collaboration, (3) observational studies as well as randomized controlled experiments and natural experiments using appropriate spatial counterfactuals and mixed methods, and (4) return-on-investment calculations of potential economic, social, and health costs and benefits of urban greening initiatives.

The health of urban Aboriginal people: insufficient data to close the gap.

PubMed

Eades, Sandra J; Taylor, Bronwen; Bailey, Sandra; Williamson, Anna B; Craig, Jonathan C; Redman, Sally

2010-11-01

The Australian Government has committed to reducing Indigenous disadvantage, including closing the life-expectancy gap within a generation, and to halving the gap in mortality rates for children under 5 years of age within a decade. Sixty per cent of the health gap between Indigenous and non-Indigenous Australians is attributable to the health of Indigenous people living in non-remote areas of Australia. We conducted a brief review of recent Australian original research publications on the health of the 53% of Indigenous people who live in urban areas, and found that data are sparse; there were only 63 studies in the past 5 years (11% of all articles about Indigenous health during this period). Although Indigenous Australians living in remote areas experience greater health disparity, the government will not achieve its aims without paying due attention to the non-remote-living population. More research is required, and particularly research that actually tests the impact of policies and programs.

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

Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch

PubMed Central

2014-01-01

In 21st-century public health, rapid urbanization and mental health disorders are a growing global concern. The relationship between diet, brain function and the risk of mental disorders has been the subject of intense research in recent years. In this review, we examine some of the potential socioeconomic and environmental challenges detracting from the traditional dietary patterns that might otherwise support positive mental health. In the context of urban expansion, climate change, cultural and technological changes and the global industrialization and ultraprocessing of food, findings related to nutrition and mental health are connected to some of the most pressing issues of our time. The research is also of relevance to matters of biophysiological anthropology. We explore some aspects of a potential evolutionary mismatch between our ancestral past (Paleolithic, Neolithic) and the contemporary nutritional environment. Changes related to dietary acid load, advanced glycation end products and microbiota (via dietary choices and cooking practices) may be of relevance to depression, anxiety and other mental disorders. In particular, the results of emerging studies demonstrate the importance of prenatal and early childhood dietary practices within the developmental origins of health and disease concept. There is still much work to be done before these population studies and their mirrored advances in bench research can provide translation to clinical medicine and public health policy. However, the clear message is that in the midst of a looming global epidemic, we ignore nutrition at our peril. PMID:25060574

Nutritional psychiatry research: an emerging discipline and its intersection with global urbanization, environmental challenges and the evolutionary mismatch.

PubMed

Logan, Alan C; Jacka, Felice N

2014-07-24

In 21st-century public health, rapid urbanization and mental health disorders are a growing global concern. The relationship between diet, brain function and the risk of mental disorders has been the subject of intense research in recent years. In this review, we examine some of the potential socioeconomic and environmental challenges detracting from the traditional dietary patterns that might otherwise support positive mental health. In the context of urban expansion, climate change, cultural and technological changes and the global industrialization and ultraprocessing of food, findings related to nutrition and mental health are connected to some of the most pressing issues of our time. The research is also of relevance to matters of biophysiological anthropology. We explore some aspects of a potential evolutionary mismatch between our ancestral past (Paleolithic, Neolithic) and the contemporary nutritional environment. Changes related to dietary acid load, advanced glycation end products and microbiota (via dietary choices and cooking practices) may be of relevance to depression, anxiety and other mental disorders. In particular, the results of emerging studies demonstrate the importance of prenatal and early childhood dietary practices within the developmental origins of health and disease concept. There is still much work to be done before these population studies and their mirrored advances in bench research can provide translation to clinical medicine and public health policy. However, the clear message is that in the midst of a looming global epidemic, we ignore nutrition at our peril.

Associations between Health Literacy and Health Behaviors among Urban High School Students

ERIC Educational Resources Information Center

Park, Aesoon; Eckert, Tanya L.; Zaso, Michelle J.; Scott-Sheldon, Lori A. J.; Vanable, Peter A.; Carey, Kate B.; Ewart, Craig K.; Carey, Michael P.

2017-01-01

Background: Health literacy is crucial to develop health-related knowledge, adopt healthy lifestyles, and benefit from health care services. However, research on the association between health literacy and adolescent health outcomes, particularly on their prospective associations, is rare. We assessed health literacy using 3 validated measures,…

US EPA’s Watershed Management Research Activities

EPA Science Inventory

The U.S. Environmental Protection Agency’s Urban Watershed Management Branch (UWMB) is responsible for developing and demonstrating methods to manage the risk to public health, property and the environment from wet-weather flows (WWF) in urban watersheds. The activities are prim...

Bridging Mental Health and Education in Urban Elementary Schools: Participatory Research to Inform Intervention Development

ERIC Educational Resources Information Center

Cappella, Elise; Jackson, Daisy R.; Bilal, Caroline; Hamre, Bridget K.; Soule, Carles

2011-01-01

Guided by participatory research and implementation science, we conducted a two-phase study to contextualize a school mental health intervention for its implementation settings. Drawing from research and existing programs, we created a teacher consultation and coaching intervention delivered by indigenous school and community mental health…

Urban Natural Environments, Obesity, and Health-Related Quality of Life among Hispanic Children Living in Inner-City Neighborhoods

PubMed Central

Kim, Jun-Hyun; Lee, Chanam; Sohn, Wonmin

2016-01-01

Although a substantial body of literature has provided evidence supporting the positive effects of natural environments on well-being, little has been known about the specific spatial patterns of urban nature in promoting health-related quality of life (HRQOL) among children. This study assessed the association that the urban natural environment measured by landscape spatial patterns may have with obesity and HRQOL among Hispanic children. Ninety-two 4th and 5th grade students were recruited from Houston, Texas, and the Pediatric Quality of Life Inventory (PedsQL) was used to capture the children’s HRQOL. The quality of urban natural environments was assessed by quantifying the landscape spatial patterns, using landscape indices generated by Geographic Information Systems and remote sensing. From the bivariate analyses, children’s body mass index showed a significantly negative association with their HRQOL. After controlling for socio-demographic factors, the results revealed that larger and more tree areas were positively correlated with children’s HRQOL. In addition, those children living in areas with tree patches further apart from each other showed higher HRQOL. This research adds to the current multi-disciplinary area of research on environment-health relationships by investigating the roles of urban greeneries and linking their spatial structures with children’s HRQOL. PMID:26771623

Urban Natural Environments, Obesity, and Health-Related Quality of Life among Hispanic Children Living in Inner-City Neighborhoods.

PubMed

Kim, Jun-Hyun; Lee, Chanam; Sohn, Wonmin

2016-01-12

Although a substantial body of literature has provided evidence supporting the positive effects of natural environments on well-being, little has been known about the specific spatial patterns of urban nature in promoting health-related quality of life (HRQOL) among children. This study assessed the association that the urban natural environment measured by landscape spatial patterns may have with obesity and HRQOL among Hispanic children. Ninety-two 4th and 5th grade students were recruited from Houston, Texas, and the Pediatric Quality of Life Inventory (PedsQL) was used to capture the children's HRQOL. The quality of urban natural environments was assessed by quantifying the landscape spatial patterns, using landscape indices generated by Geographic Information Systems and remote sensing. From the bivariate analyses, children's body mass index showed a significantly negative association with their HRQOL. After controlling for socio-demographic factors, the results revealed that larger and more tree areas were positively correlated with children's HRQOL. In addition, those children living in areas with tree patches further apart from each other showed higher HRQOL. This research adds to the current multi-disciplinary area of research on environment-health relationships by investigating the roles of urban greeneries and linking their spatial structures with children's HRQOL.

Examining the relationship between social support availability, urban center size, and self-perceived mental health of recent immigrants to Canada: a mixed-methods analysis.

PubMed

Chadwick, Kathryn A; Collins, Patricia A

2015-03-01

The experiences of settlement in a new country (e.g., securing housing and employment, language barriers) pose numerous challenges for recent immigrants that can impede their health and well-being. Lack of social support upon arrival and during settlement may help to explain why immigrant mental health status declines over time. While most urban centers in Canada offer some settlement services, little is known about how the availability of social supports, and the health statuses of recent immigrants, varies by city size. The objective of this mixed-methods study was to examine the relationship between self-perceived mental health (SPMH), social support availability, and urban center size, for recent immigrants to Canada. The quantitative component involved analysis of 2009-2010 Canadian Community Health Survey data, selecting for only recent immigrants and for those living in either large or small urban centers. The qualitative component involved in-depth interviews with managers of settlement service organizations located in three large and three small urban centers in Canada. The quantitative analysis revealed that social support availability is positively associated with higher SPMH status, and is higher in small urban centers. In support of these findings, our interviews revealed that settlement service organizations operating in small urban centers offer more intensive social supports; interviewees attributed this difference to personal relationships in small cities, and the ease with which they can connect to other agencies to provide clients with necessary supports. Logistic regression analysis revealed, however, that recent immigrants in small urban centers are twice as likely to report low SPMH compared to those living in large urban centers. Thus, while the scope and nature of settlements services appears to vary by city size in Canada, more research is needed to understand what effect settlement services have on the health status of recent immigrants to Canada, especially in smaller urban centers. Copyright © 2015. Published by Elsevier Ltd.

Participation in productive activities and health outcomes among older adults in urban China.

PubMed

Li, Yawen; Xu, Ling; Chi, Iris; Guo, Ping

2014-10-01

This study examined whether participating in productive activities was associated with better health outcomes among older adults in urban China, including analysis of potential gender differences. Using a sample of 10,016 urban Chinese adults aged 60 years or older from the 2006 Sample Survey of the Aged Population in Urban/Rural China, we regressed measures of self-rated health, functional health, and depression on productive activities (paid employment, helping with family, and volunteering), controlling for sociodemographic variables. Those who provided assistance to family members or volunteered had significantly lower levels of depression and better functional and self-rated health than their counterparts. Older adults with paid job, providing family assistance, or volunteering reported significantly lower levels of depression and better functional and self-rated health than those without those activities. However, only older men with paid employment reported significantly less depression, and the effect of family assistance on functional health also differed by gender. As research increasingly demonstrates the role of productive activities in maintaining health among older adults, our findings can help practitioners or policy makers strategically select or develop health programs to promote productive activities among older adults in urban China. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

Urbanisation, urbanicity, and health: a systematic review of the reliability and validity of urbanicity scales.

PubMed

Cyril, Sheila; Oldroyd, John C; Renzaho, Andre

2013-05-28

Despite a plethora of studies examining the effect of increased urbanisation on health, no single study has systematically examined the measurement properties of scales used to measure urbanicity. It is critical to distinguish findings from studies that use surrogate measures of urbanicity (e.g. population density) from those that use measures rigorously tested for reliability and validity. The purpose of this study was to assess the measurement reliability and validity of the available urbanicity scales and identify areas where more research is needed to facilitate the development of a standardised measure of urbanicity. Databases searched were MEDLINE with Full Text, CINAHL with Full Text, and PsycINFO (EBSCOhost) as well as Embase (Ovid) covering the period from January 1970 to April 2012. Studies included in this systematic review were those that focused on the development of an urbanicity scale with clearly defined items or the adoption of an existing scale, included at least one outcome measure related to health, published in peer-reviewed journals, the full text was available in English and tested for validity and reliability. Eleven studies met our inclusion criteria which were conducted in Sri Lanka, Austria, China, Nigeria, India and Philippines. They ranged in size from 3327 to 33,404 participants. The number of scale items ranged from 7 to 12 items in 5 studies. One study measured urban area socioeconomic disadvantage instead of urbanicity. The emerging evidence is that increased urbanisation is associated with deleterious health outcomes. It is possible that increased urbanisation is also associated with access and utilisation of health services. However, urbanicity measures differed across studies, and the reliability and validity properties of the used scales were not well established. There is an urgent need for studies to standardise measures of urbanicity. Longitudinal cohort studies to confirm the relationship between increased urbanisation and health outcomes are urgently needed.

Urbanisation, urbanicity, and health: a systematic review of the reliability and validity of urbanicity scales

PubMed Central

2013-01-01

Background Despite a plethora of studies examining the effect of increased urbanisation on health, no single study has systematically examined the measurement properties of scales used to measure urbanicity. It is critical to distinguish findings from studies that use surrogate measures of urbanicity (e.g. population density) from those that use measures rigorously tested for reliability and validity. The purpose of this study was to assess the measurement reliability and validity of the available urbanicity scales and identify areas where more research is needed to facilitate the development of a standardised measure of urbanicity. Methods Databases searched were MEDLINE with Full Text, CINAHL with Full Text, and PsycINFO (EBSCOhost) as well as Embase (Ovid) covering the period from January 1970 to April 2012. Studies included in this systematic review were those that focused on the development of an urbanicity scale with clearly defined items or the adoption of an existing scale, included at least one outcome measure related to health, published in peer-reviewed journals, the full text was available in English and tested for validity and reliability. Results Eleven studies met our inclusion criteria which were conducted in Sri Lanka, Austria, China, Nigeria, India and Philippines. They ranged in size from 3327 to 33,404 participants. The number of scale items ranged from 7 to 12 items in 5 studies. One study measured urban area socioeconomic disadvantage instead of urbanicity. The emerging evidence is that increased urbanisation is associated with deleterious health outcomes. It is possible that increased urbanisation is also associated with access and utilisation of health services. However, urbanicity measures differed across studies, and the reliability and validity properties of the used scales were not well established. Conclusion There is an urgent need for studies to standardise measures of urbanicity. Longitudinal cohort studies to confirm the relationship between increased urbanisation and health outcomes are urgently needed. PMID:23714282

EXPOSURE MONITORING COMPONENT FOR DETROIT CHILDREN'S HEALTH STUDY ( DCHS )

EPA Science Inventory

Conventional, regulatory-based air monitoring is expensive and, thus, conducted at one or few locations in a city. This provides limited info on intra-urban variability and spatial distribution of air pollution. Research-oriented urban network monitoring has progressed with inc...

[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.

Disparities in home health service providers among Medicare beneficiaries with stroke.

PubMed

Iyer, Medha; Bhavsar, Grishma P; Bennett, Kevin J; Probst, Janice C

2016-01-01

This study examined the intensity of home health services, as defined by the number of visits and service delivery by rehabilitation specialists, among Medicare beneficiaries with stroke. A cross-sectional secondary data analysis was conducted using 2009 home health claims data obtained from the Centers for Medicare and Medicaid Services' Research Data Assistance Center. There were no significant rural-urban differences in the number of home health visits. Rural beneficiaries were significantly less likely than urban beneficiaries to receive services from rehabilitation specialists. Current home health payment reform recommendations may have unintended consequences for rural home health beneficiaries who need therapy services.

Mental Health Condition of the Only-Child: A Study of Urban and Rural High School Students in China

ERIC Educational Resources Information Center

Liu, Chenying; Munakata, Tsunetsugu; Onuoha, Francis N.

2005-01-01

The mental health of the only-child continues to generate interest in research literature. The present study examines the issue in China, where the one-child phenomenon is highest due to deliberate government policy. Subjects are 299 and 333 students in two high-rank high schools in urban Harebin and rural Qing an Xian, respectively (mean age =…

[Urban shrinkage and challenges for the public health-care service].

PubMed

Kabisch, S

2007-10-01

In the 21st century, urban development is facing new challenges caused by the simultaneous growing and shrinking of cities and urban regions. Whilst the development patterns and instruments of urban growth are well-known and widely accepted, the processes of shrinkage with its broad consequences, sphere of impact and speed need intensive investigation. In particular, urban restructuring including housing demolition brings about psychological stress situations for the affected inhabitants. Until the present time public services, including health-care, are poorly prepared to cope with the new situation. To take account of these new challenges, the adaptation of tasks, instruments and targets is urgently needed. To be successful, a continuous cooperation and communication between municipal institutions and housing enterprises responsible for urban and housing development is indispensable. Furthermore, appropriately focussed scientific research results can support the creation of adequate strategies and instruments.

Studies in Adolescent Health: Research to Improve Health Services for Mothers and Children.

ERIC Educational Resources Information Center

California Univ., Los Angeles. School of Public Health.

This publication is one in a series summarizing final reports of research projects concerned with improving health services for mothers, children and physically handicapped youth. Topics of the 10 reports include: (1) ambulatory care patterns of urban adolescents in New York City, (2) selected parameters of school achievement among New York City…

Thinking inside the bubble: evidence for a new contextual unit in urban mental health

PubMed Central

Whitley, R.; Prince, M.; Cargo, M.

2005-01-01

Objective: Previous quantitative research has suggested that there is a link between housing, the urban environment, and mental health. However, methodological and design issues make it difficult to disentangle the relative influence of dwelling specific and wider urban environmental influences on individual mental health. The aim of this study was to explore the link between the dwelling, the immediate urban environment, and mental health to generate a new conceptual framework by which understanding of dwelling and urban environmental influences on mental health can be advanced. Design and participants: Qualitative interviews and focus groups were conducted with 32 inner city residents. Participants, stratified by sex and mental health status, were randomly recruited from a wider quantitative survey. An almost equal number of men and women as well as people with or without mental health problems participated, allowing for comparison of experience. Data were analysed inductively to generate an appropriate theoretical framework regarding dwelling and urban environmental influences on mental health. Setting: An inner city neighbourhood of about 6200 people in north west London. Most of that population live in public housing. Main results: The principal study finding is that between the dwelling unit and the neighbourhood unit, evidence was found for another meaningful contextual unit of analysis, the "residential bubble" through which effects on mental health can be mediated. The residential bubble describes a limited area of three dimensional space that surrounds a dwelling, encompassing immediate neighbours (above, below, and adjacent) and shared public space bordering the dwelling. Positive events and processes within the bubble had a beneficial influence on mental health whereas negative ones tended to have a damaging influence. These seemed to disproportionately have an impact on people with pre-existing mental health problems. Conclusion: The concept of the "residential bubble" may be a meaningful new contextual unit of analysis in urban mental health. This may have important implications with regards to interventions and measurement development. PMID:16166366

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.

Adding Natural Areas to Social Indicators of Intra-Urban Health Inequalities among Children: A Case Study from Berlin, Germany.

PubMed

Kabisch, Nadja; Haase, Dagmar; Annerstedt van den Bosch, Matilda

2016-08-04

Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children's health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools.

Adding Natural Areas to Social Indicators of Intra-Urban Health Inequalities among Children: A Case Study from Berlin, Germany

PubMed Central

Kabisch, Nadja; Haase, Dagmar; Annerstedt van den Bosch, Matilda

2016-01-01

Research suggests that there is a relationship between the health of urban populations and the availability of green and water spaces in their daily environment. In this paper, we analyze the potential intra-urban relationships between children’s health determinants and outcomes and natural areas in Berlin, Germany. In particular, health indicators such as deficits in viso-motoric development in children are related to environmental indicators such as the natural area cover, natural area per capita and distance to natural areas; however, these indicators are also correlated with social determinants of health. The methodological approach used in this study included bivariate and multivariate analyses to explore the relations between health inequalities and social, socio-economic, and land use parameters. The results on a sub-district level indicated that there was a correlation between natural areas and social health determinants, both of which displayed a certain intra-urban spatial pattern. In particular, a lower percentage of natural area cover was correlated with deficits in viso-motoric development. However, results with percentage of natural area cover and per capita natural area with childhood overweight were not conclusive. No significant correlation was found for percentage of natural area cover and overweight, while significant negative correlation values were found between overweight and per capita natural area. This was identified particularly in the districts that had lower social conditions. On the other hand, the districts with the highest social conditions had the comparatively lowest levels of complete measles immunization. This study may facilitate public health work by identifying the urban areas in which the strengthening of health resources and actions should be prioritized and also calls for the inclusion of natural areas among the social health indicators included in intra-urban health inequality tools. PMID:27527197

NYC Epi Scholars program: promoting applied health disparities research in an urban public health department-a program model.

PubMed

Blake, Janice; Choden, Tsering; Hemans-Henry, Calaine; Koppaka, Ram; Greene, Carolyn

2011-01-01

Although health disparities research has already contributed to decreased mortality and morbidity in underserved communities, more work is needed. The NYC Epi Scholars program of the New York City Department of Health and Mental Hygiene (NYC DOHMH) aims to address gaps in critical public health needs and to train future public health leaders in epidemiology. The program is designed to increase racial/ethnic and socioeconomic diversity in the public health workforce, to provide fieldwork and practica opportunities, and to cultivate future leaders in epidemiology and public health. Since its inception in 2007, the NYC Epi Scholars program of the NYC DOHMH has sought talented epidemiology students interested in gaining practical experience in applied health disparities research. NYC Epi Scholars is open to graduate epidemiology students who have demonstrated achievement and leadership potential and gives them an opportunity to provide high-quality research assistance to projects that identify and address health disparities of public health significance. Many of the program's 32 alumni have made notable contributions to public health: publishing articles in peer-reviewed journals; making presentations at national and international conferences; and after graduating, pursuing careers at the DOHMH, Centers for Disease Control and Prevention, the Environmental Protection Agency, and the National Institutes of Health. Because of its noted success, the NYC Epi Scholars program may serve as a "best-practice" model for expansion in other urban health departments.

Needed: Global Collaboration for Comparative Research on Cities and Health

PubMed Central

Gusmano, Michael K.; Rodwin, Victor G.

2016-01-01

Over half of the world’s population lives in cities and United Nations (UN) demographers project an increase of 2.5 billion more urban dwellers by 2050. Yet there is too little systematic comparative research on the practice of urban health policy and management (HPAM), particularly in the megacities of middle-income and developing nations. We make a case for creating a global database on cities, population health and healthcare systems. The expenses involved in data collection would be difficult to justify without some review of previous work, some agreement on indicators worth measuring, conceptual and methodological considerations to guide the construction of the global database, and a set of research questions and hypotheses to test. We, therefore, address these issues in a manner that we hope will stimulate further discussion and collaboration. PMID:27694667

Needed: Global Collaboration for Comparative Research on Cities and Health.

PubMed

Gusmano, Michael K; Rodwin, Victor G

2016-04-16

Over half of the world's population lives in cities and United Nations (UN) demographers project an increase of 2.5 billion more urban dwellers by 2050. Yet there is too little systematic comparative research on the practice of urban health policy and management (HPAM), particularly in the megacities of middle-income and developing nations. We make a case for creating a global database on cities, population health and healthcare systems. The expenses involved in data collection would be difficult to justify without some review of previous work, some agreement on indicators worth measuring, conceptual and methodological considerations to guide the construction of the global database, and a set of research questions and hypotheses to test. We, therefore, address these issues in a manner that we hope will stimulate further discussion and collaboration. © 2016 by Kerman University of Medical Sciences.

The Role of Open Space in Urban Neighbourhoods for Health-Related Lifestyle

PubMed Central

Lestan, Katarina Ana; Eržen, Ivan; Golobič, Mojca

2014-01-01

The research reported in this paper addresses the relationship between quality of open space and health related lifestyle in urban residential areas. The research was performed in the residential developments in Ljubljana, Slovenia, dating from the time of political and economic changes in the early nineties. Compared to the older neighborhoods, these are typically single-use residential areas, with small open spaces and poor landscape design. The research is concerned with the quality of life in these areas, especially from the perspective of the vulnerable users, like the elderly and children. Both depend on easily accessible green areas in close proximity to their homes. The hypothesis is that the poor open space quality affects their health-related behavior and their perceived health status. The research has three methodological phases: (1) a comparison between urban residential areas by criteria describing their physical characteristics; (2) behavior observation and mapping and (3) a resident opinion survey. The results confirm differences between open spaces of the selected residential areas as well as their relation with outdoor activities: a lack of outdoor programs correlates with poor variety of outdoor activities, limited to transition type, less time spent outdoors and lower satisfaction with their home environment. The survey also disclosed a strong influence of a set of socio-economic variables such as education and economic status on physical activity and self-perceived health status of people. The results therefore confirm the hypothesis especially for less affluent and educated; i.e., vulnerable groups. PMID:25003173

Health effects of perceived racial and religious bullying among urban adolescents in China: a cross-sectional national study.

PubMed

Pan, Stephen W; Spittal, Patricia M

2013-07-01

Research concerning ethnocultural bullying and adolescent health in China remains extremely limited. This study among Chinese urban adolescents examines associations between ethnocultural bullying and eight health-related outcomes: suicidal ideation, suicide planning, depressive symptomology, anxiety symptomatology, fighting, injury intentionally inflicted by another, smoking and moderate/heavy alcohol consumption. Data were obtained from the World Health Organisation's 2003 Chinese Global School-based Health Survey, a cross-sectional national survey of urban adolescents in four Chinese cities. The analytic sample size was n = 8182, which represented a sampling frame of 769,835 adolescents. Statistical analysis was conducted using generalised linear mixed effects models and sampling weights. Prevalence of ethnocultural bullying was significantly higher in Urumqi, Xinjiang province (2.08%) compared with Beijing municipality (0.72%) or Wuhan, Hubei province (0.67%). Compared to participants who were not bullied, religious bullying victimisation was significantly associated with suicidal ideation, injury intentionally inflicted by another and depressive symptomology. Racial bullying victimisation was significantly associated with suicidal ideation, injury intentionally inflicted by another and among females but not males, depressive symptomology. Health effects of ethnocultural bullying appear to be distinct from that of bullying in general. Additional research on ethnocultural adolescent health issues in China is warranted.

Public parks and wellbeing in urban areas of the United States

Treesearch

Lincoln R. Larson; Viniece Jennings; Scott A. Cloutier

2016-01-01

Sustainable development efforts in urban areas often focus on understanding and managing factors that influence all aspects of health and wellbeing. Research has shown that public parks and green space provide a variety of physical, psychological, and social benefits to urban residents, but few studies have examined the influence of parks on comprehensive measures of...

Attending to Communication and Patterns of Interaction: Culturally Sensitive Mental Health Care for Groups of Urban, Ethnically Diverse, Impoverished, and Underserved Women.

PubMed

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

2014-07-01

The United States is ethnically diverse. This diversity presents challenges to nurses, who, without empirical evidence to design culturally congruent interventions, may contribute to mental health care disparities. Using Leininger's theory of culture care diversity and universality, this study documented communication and interaction patterns of ethnically diverse, urban, impoverished, and underserved women. Using a community-based participatory research framework, 61 Black, Hispanic, and White women participated in focus groups around their experiences with anxiety/depression. Researchers recorded verbal communication, nonverbal behavior, and patterns of interaction. The women's communication and interaction patterns gave evidence of three themes that were evident across all focus groups and five subthemes that emerged along ethnic lines. The results suggest cultural universalities and cultural uniquenesses relative to the communication and interaction patterns of urban, ethnically diverse, impoverished, and underserved women that may assist in the design of culturally sensitive mental health care. © The Author(s) 2014.

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.

The impact of intimate partner violence, substance use, and HIV on depressive symptoms among abused low-income urban women.

PubMed

Illangasekare, Samantha L; Burke, Jessica G; McDonnell, Karen A; Gielen, Andrea C

2013-09-01

Intimate partner violence (IPV), substance use, and HIV are often co-occuring health problems affecting low-income urban women, and have been described as connected epidemics making up a "syndemic." Research suggests that each issue separately is associated with depressive symptoms, but no studies have examined the combined effect of IPV, substance use and HIV on women's depression. Interviews were conducted with 96 women recruited from community health clinics serving low-income women in an urban U.S. city. All women were over 17, not pregnant, English-speaking, without private insurance and had experienced physical IPV in the past year. Women were primarily African American (82%) and 82% were receiving income assistance. Twenty seven percent were HIV-positive, and 27% had used heroin or cocaine in the past 6 months. Based on the Centers for Epidemiological Studies Depression Scale (CES-D ), 73% were depressed. Women who experienced severe IPV in the past 6 months were compared to women who experienced no IPV or psychological IPV only in the past 6 months; those who experienced severe IPV were 5.3 times more likely to be depressed, controlling for HIV status, drug use, age, and relationship status. Women who experienced severe IPV, were HIV-positive, and used drugs (7.3% of sample) were 7.98 times as likely to be depressed as women without these characteristics. These findings confirm that severe IPV is significantly associated with depression among urban abused women. Furthermore, this research suggests that the syndemic effect of IPV, substance use, and HIV could be even more detrimental to women's mental health. Health practitioners and researchers should be aware of the combined impact of the IPV, substance use, and HIV syndemic and consider how they can address the mental health needs of urban women.

Sustainability for Shrinking Cities | Science Inventory | US EPA

EPA Pesticide Factsheets

Shrinking cities are widespread throughout the world despite the rapidly increasing global urban population. These cities are attempting to transition to sustainable trajectories to improve the health and well-being of urban residents, to build their capacity to adapt to changing conditions and to cope with major events. The dynamics of shrinking cities are different than the dynamics of growing cities, and therefore intentional research and planning around creating sustainable cities is needed for shrinking cities. We propose research that can be applied to shrinking cities by identifying parallel challenges in growing cities and translating urban research and planning that is specific to each city’s dynamics. In addition, we offer applications of panarchy concepts to this problem. The contributions to this Special Issue take on this forward-looking planning task through drawing lessons for urban sustainability from shrinking cities, or translating general lessons from urban research to the context of shrinking cities. Humans are rapidly becoming an urban species, with greater populations in urban areas, increasing size of these urban areas, and increasing number of very large urban areas. As a consequence, much of what we know about cities is focused on how they grow and take shape, the strains that their growth puts on city infrastructure, the consequences for human and nonhuman inhabitants of these cities and their surroundings, and the policies which can

Health Information Seeking Behaviors of Ethnically Diverse Adolescents

PubMed Central

Okoniewski, Anastasia E.; Lee, Young Ji; Rodriguez, Martha; Schnall, Rebecca; Low, Alexander F. H.

2013-01-01

Research on health information has primarily focused on the needs of adults or parents of children with chronic illnesses or consumers. There is limited research on the health information needs of adolescents and in particular those from underserved communities. The primary objective of this qualitative study was to understand the health information needs of healthy, urban adolescents, and how they met those needs. Focus group methodology was used to gather information from a sample of ethnically diverse urban adolescents. Data was analyzed using Kriekelas’ Information Seeking Behavior framework to, examine the participants” report of their immediate and deferred health information needs. Our sample of adolescents used several different sources to satisfy their health information needs depending on acuity and severity, which was congruent with Kriekelas’ framework. Understanding how adolescents use technology to meet their health information needs, and in what order of preference, will be critical for the development of technology that adolescents find useful and has the potential to decrease health disparities. PMID:23512322

Weight- and race-based bullying: health associations among urban adolescents.

PubMed

Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R

2015-04-01

Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects. © The Author(s) 2013.

Weight- and race-based bullying: Health associations among urban adolescents

PubMed Central

Rosenthal, Lisa; Earnshaw, Valerie A; Carroll-Scott, Amy; Henderson, Kathryn E; Peters, Susan M; McCaslin, Catherine; Ickovics, Jeannette R

2014-01-01

Stigma-based bullying is associated with negative mental and physical health outcomes. In a longitudinal study, surveys and physical assessments were conducted with mostly Black and Latino, socioeconomically disadvantaged, urban students. As hypothesized, greater weight- and race-based bullying each was significantly indirectly associated with increased blood pressure and body mass index, as well as decreased overall self-rated health across 2 years, through the mechanism of more negative emotional symptoms. Results support important avenues for future research on mechanisms and longitudinal associations of stigma-based bullying with health. Interventions are needed to reduce stigma-based bullying and buffer adolescents from adverse health effects. PMID:24155192

The Impact of Urban US Policing Practices on Black Men Who Have Sex with Men's HIV Vulnerability: Ethnographic Findings and a Conceptual Model for Future Research.

PubMed

Parker, Caroline M; Parker, Richard G; Philbin, Morgan M; Hirsch, Jennifer S

2018-04-01

This paper advances research on racism and health by presenting a conceptual model that delineates pathways linking policing practices to HIV vulnerability among Black men who have sex with men in the urban USA. Pathways include perceived discrimination based on race, sexuality and gender performance, mental health, and condom-carrying behaviors. The model, intended to stimulate future empirical work, is based on a review of the literature and on ethnographic data collected in 2014 in New York City. This paper contributes to a growing body of work that examines policing practices as drivers of racial health disparities extending far beyond violence-related deaths.

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

Urban environmental health applications of remote sensing

NASA Technical Reports Server (NTRS)

Rush, M.; Goldstein, J.; Hsi, B. P.; Olsen, C. B.

1974-01-01

An urban area was studied through the use of the inventory-by-surrogate method rather than by direct interpretation of photographic imagery. Prior uses of remote sensing in urban and public research are examined. The effects of crowding, poor housing conditions, air pollution, and street conditions on public health are considered. Color infrared photography was used to categorize land use features and the grid method was used in photo interpretation analysis. The incidence of shigella and salmonella, hepatitis, meningitis, tuberculosis, myocardial infarction and veneral disease were studied, together with mortality and morbidity rates. Sample census data were randomly collected and validated. The hypothesis that land use and residential quality are associated with and act as an influence upon health and physical well-being was studied and confirmed.

Medical and licit drug use in an urban/rural study population with a refugee background, 7-8 years into resettlement

PubMed Central

Johansson Blight, Karin; Persson, Jan-Olov; Ekblad, Solvig; Ekberg, Jan

2008-01-01

Objective: Research into medical and licit drug use in resettled refugee populations is scarce, despite the fact that mental health status often has been found to be poorer than in general populations. Hence the aim of this study was to estimate the prevalence of self-rated use of medicine and licit drugs among adults who came to Sweden from Bosnia-Herzegovina (1993/94) and who in 2001 were living in either an urban (low employment context) or a rural (high employment context) region (n=4185). Methods: Prevalence was estimated from a cross-sectional questionnaire distributed to a representative sample (n=650) in 2001 (63.5% response rate). Results: The study population estimates of usage of sedatives (26.5%), sleeping tablets (26.2%) and antidepressants (22.3%) did not differ by gender but did so by region, with a higher urban prevalence. The consumption of alcohol (5.1%) and cigarettes (41.0%) did not differ by region but men reported higher alcohol consumption than women. Conclusion: The high consumption of medicine (compared with general populations) raises the question of treatment efficiency and the need for public health attention and evaluation many years after resettlement. Factors to consider for further research with analytic prerequisites concern indications that regional differences may be influenced, not only by urban employment being lower but also by urban/rural differences in prescription rates and/or access to health care; moreover, there might have been a selection to the urban region of older people, with a more vulnerable family situation, and/or poorer mental health. Finally, the overall alcohol (low) and cigarettes (high) consumption in the study population followed prevalence patterns found in Bosnia-Herzegovina rather than in Sweden. PMID:19742286

Self-rated health status and subjective health complaints associated with health-promoting lifestyles among urban Chinese women: a cross-sectional study.

PubMed

Cheng, Jingru; Wang, Tian; Li, Fei; Xiao, Ya; Bi, Jianlu; Chen, Jieyu; Sun, Xiaomin; Wu, Liuguo; Wu, Shengwei; Liu, Yanyan; Luo, Ren; Zhao, Xiaoshan

2015-01-01

This study aimed to investigate whether self-rated health status (SRH) and subjective health complaints (SHC) of urban Chinese women are associated with their health-promoting lifestyles (HPL). We conducted a cross-sectional study on 8142 eligible Chinese participants between 2012 and 2013. Demographic and SHC data were collected. Each subject completed the SRH questionnaire and the Chinese version of the Health-Promoting Lifestyle Profile-II (HPLP-II). Correlation and binary regression analyses were performed to examine the associations of SRH and SHC with HPL. Both SRH and HPL of urban Chinese women were moderate. The most common complaints were fatigue (1972, 24.2%), eye discomfort (1571, 19.3%), and insomnia (1542, 18.9%). Teachers, highly educated subjects and elderly women had lower SRH scores, while college students and married women had better HPL. All items of HPLP-II were positively correlated with SRH (r = 0.127-0.533, P = 0.000) and negatively correlated with SHC to a significant extent (odds ratio [OR] = 1.40-11.37). Aspects of HPL, particularly stress management and spiritual growth, are associated with higher SRH and lower SHC ratings among urban Chinese women. Physical activity and health responsibility are additionally related to reduced fatigue and nervousness. We believe that these findings will be instrumental in encouraging researchers and urban women to adopt better health-promoting lifestyles with different priorities in their daily lives.

Air pollution from household solid fuel combustion in India: an overview of exposure and health related information to inform health research priorities.

PubMed

Balakrishnan, Kalpana; Ramaswamy, Padmavathi; Sambandam, Sankar; Thangavel, Gurusamy; Ghosh, Santu; Johnson, Priscilla; Mukhopadhyay, Krishnendu; Venugopal, Vidhya; Thanasekaraan, Vijayalakshmi

2011-01-01

Environmental and occupational risk factors contribute to nearly 40% of the national burden of disease in India, with air pollution in the indoor and outdoor environment ranking amongst leading risk factors. It is now recognized that the health burden from air pollution exposures that primarily occur in the rural indoors, from pollutants released during the incomplete combustion of solid fuels in households, may rival or even exceed the burden attributable to urban outdoor exposures. Few environmental epidemiological efforts have been devoted to this setting, however. We provide an overview of important available information on exposures and health effects related to household solid fuel use in India, with a view to inform health research priorities for household air pollution and facilitate being able to address air pollution within an integrated rural-urban framework in the future.

"I'm always entirely happy when I'm here!" Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany.

PubMed

Völker, Sebastian; Kistemann, Thomas

2013-02-01

Water is one of the most important landscape elements. In settled areas, planners rediscovered urban blue in the form of rivers as a soft location factor in post-industrial times. Although the recognition of the need for recreational or 'healthy' places like urban green or urban blue in cities is increasing, current urban planning is mostly conducted without taking beneficial health issues into account. In this paper an extended concept of therapeutic landscapes is used to analyse two promenades on the river Rhine in the centres of two German cities (Cologne and Düsseldorf). A complex of qualitative and quantitative methods from diverse disciplines is applied to obtain a multi-dimensional image of salutogenic health processes. The results show that the promenades are favourite places to spend leisure time and to engage in recreational activities, in addition to providing restoration from everyday stresses. Water is a strong predictor of preference and positive perceptive experiences in urban environments. Users of the promenades also report strong emotional attachments to the place. Urban blue space may be interpreted as a therapeutic landscape in various ways. The study forms a contribution to planning issues, particularly considering benefits for human health, and enhances current research concerning therapeutic landscapes. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reprint of: "I'm always entirely happy when I'm here!" Urban blue enhancing human health and well-being in Cologne and Düsseldorf, Germany.

PubMed

Völker, Sebastian; Kistemann, Thomas

2013-08-01

Water is one of the most important landscape elements. In settled areas, planners rediscovered urban blue in the form of rivers as a soft location factor in post-industrial times. Although the recognition of the need for recreational or 'healthy' places like urban green or urban blue in cities is increasing, current urban planning is mostly conducted without taking beneficial health issues into account. In this paper an extended concept of therapeutic landscapes is used to analyse two promenades on the river Rhine in the centres of two German cities (Cologne and Düsseldorf). A complex of qualitative and quantitative methods from diverse disciplines is applied to obtain a multi-dimensional image of salutogenic health processes. The results show that the promenades are favourite places to spend leisure time and to engage in recreational activities, in addition to providing restoration from everyday stresses. Water is a strong predictor of preference and positive perceptive experiences in urban environments. Users of the promenades also report strong emotional attachments to the place. Urban blue space may be interpreted as a therapeutic landscape in various ways. The study forms a contribution to planning issues, particularly considering benefits for human health, and enhances current research concerning therapeutic landscapes. Copyright © 2012 Elsevier Ltd. All rights reserved.

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.

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.

The diffusion of youth-led participatory research in urban schools: the role of the prevention support system in implementation and sustainability.

PubMed

Ozer, Emily J; Cantor, Jeremy P; Cruz, Gary W; Fox, Brian; Hubbard, Elizabeth; Moret, Lauren

2008-06-01

This article discusses the dissemination of a process of youth-led participatory research in urban secondary schools within the Interactive Systems Framework for Dissemination and Implementation (ISF) developed in collaboration with the CDC and its university partners (Wandersman et al. American Journal of Community Psychology, 41(3-4) 2008). The focus here is on the development of the Prevention Support System with respect to general and innovation-specific capacity building. The specific process under study involves youth-led needs assessment and research to inform the planning of prevention programs and policies to address students' health and developmental needs. The article first briefly describes the youth-led research process, its potential benefits, and a case example in two urban secondary schools. It then describes challenges and responses in providing support for the diffusion of this model in 6 secondary schools. The settings are urban public schools with a majority of students of color from diverse ethnic groups: Asian-American, Latino, and African-American. This project constitutes a collaborative partnership with a university school of public health and community-based organizations (CBOs) to build capacity for long-term, sustainable implementation of this innovative process within the local school system. The perspectives of the university-based researcher and the CBO partners on the development and effectiveness of the Prevention Support System are presented.

Developing a European urban health indicator system: results of EURO-URHIS 1.

PubMed

Patterson, Lesley; Heller, Richard; Robinson, Jude; Birt, Christopher A; van Ameijden, Erik; Bocsan, Ioan; White, Chris; Skalkidis, Yannis; Bothra, Vinay; Onyia, Ifeoma; Hellmeier, Wolfgang; Lyshol, Heidi; Gemmell, Isla; Spencer, Angela; Klumbiene, Jurate; Krampac, Igor; Rajnicova, Iveta; Macherianakis, Alexis; Bourke, Michael; Harrison, Annie; Verma, Arpana

2017-05-01

More than half of the world's population now live in cities, including over 70% in Europe. Cities bring opportunities but can be unhealthy places to live. The poorest urban dwellers live in the worst environments and are at the greatest risk of poor health outcomes. EURO-URHIS 1 set out to compile a cross-EU inventory of member states use of measures of urban health in order to support policymakers and improve public health policy. Following a literature review to define terms and find an appropriate model to guide urban health research, EURO-URHIS Urban Areas in all EU member states except Luxembourg, as well as Croatia, Turkey, Macedonia, Iceland and Norway, were defined and selected in collaboration with project partners. Following piloting of the survey tool, a the EURO-URHIS 45 data collection tool was sent out to contacts in all countries with identified EUA's, asking for data on 45 Urban Health Indicators (UHI) and 10 other indicators. 60 questionnaires were received from 30 countries, giving information on local health indicator availability, definitions and sources. Telephone interviews were also conducted with 14 respondents about their knowledge of sources of urban health data and barriers or problems experienced when collecting the data. Most participants had little problem identifying the sources of data, though some found that data was not always routinely recorded and was held by diverse sources or not at local level. Some participants found the data collection instrument to not be user-friendly and with UHI definitions that were sometimes unclear. However, the work has demonstrated that urban health and its measurement is of major relevance and importance for Public Health across Europe. The current study has constructed an initial system of European UHIs to meet the objectives of the project, but has also clearly demonstrated that further development work is required. The importance and value of examining UHIs has been confirmed, and the scene has been set for further studies on this topic. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Relationships between income inequality and health: a study on rural and urban regions of Canada.

PubMed

Vafaei, Afshin; Rosenberg, Mark W; Pickett, William

2010-01-01

Many studies have demonstrated that health is a function of relative and not absolute income within populations. Canadian studies are not conclusive; most indicate that there is no relationship between income inequality and health within Canada. There is a need for further investigation into the validity of the 'relative income' hypothesis in the Canadian population. The primary objective of this research was to test the 'relative income' hypothesis across Canadian health regions. The second objective was to extend the hypothesis to consider rural versus urban populations. This research involved ecological analyses. The source of the data was the Canadian Community Health Survey, Cycle 3.1. The units of analysis were Canadian health regions. Health of a region was estimated as the percentage of people who rated their health as good or excellent. The primary exposure variable was the ratio of people whose personal income was less than $15,000 relative to those reporting more than $80,000 in the year preceding the survey. This ratio provided a measure of the distribution of income. The main covariates were ecological measures of socio-demographic variables, social capital, substance use behaviours (smoking and alcohol consumption), rural/urban status of the region, and absolute income in the region. Correlation analyses and multiple linear regressions were performed to ascertain the relationship between income inequality and population health, adjusting for important covariates. The measure of income inequality alone appeared to explain 18% of the variability in the measure of population health. However, after adding the measure of absolute income to the model, although 29% of the variability was explained, the independent contribution of the inequality measure became non-significant. Linear regression models suggested that the absolute income variable alone could explain 30% of the variance in the health status of populations. Other variables with a statistically significant contribution to the final model were education and alcohol consumption. The effect of rural/urban geographic status on the relationship of interest was similar to other covariates. This variable did not change the individual relationship between income inequality or absolute income and the measure of population health status. In both rural and urban regions, absolute income and education had positive effects on population health. In urban regions alcohol consumption was a significant negative contributor to population health status; whereas, in rural regions, smoking status had a significant negative effect on population health status. Across Canadian health regions, health status in populations was a function of absolute income but not relative income. Regions with higher levels of education had better levels of self-rated health. A larger percentage of heavy drinkers was also correlated with lower population health status. Findings were consistently observed in rural and urban populations. The study findings have implications for public health, economic, and social policies.

Health inequalities among rural and urban population of Eastern Poland in the context of sustainable development.

PubMed

Pantyley, Viktoriya

2017-09-21

The primary goals of the study were a critical analysis of the concepts associated with health from the perspective of sustainable development, and empirical analysis of health and health- related issues among the rural and urban residents of Eastern Poland in the context of the sustainable development of the region. The study was based on the following research methods: a systemic approach, selection and analysis of the literature and statistical data, developing a special questionnaire concerning socio-economic and health inequalities among the population in the studied area, field research with an interview questionnaire conducted on randomly-selected respondents (N=1,103) in randomly selected areas of the Lubelskie, Podkarpackie, Podlaskie and eastern part of Mazowieckie Provinces (with the division between provincial capital cities - county capital cities - other cities - rural areas). The results of statistical surveys in the studied area with the use of chi-square test and contingence quotients indicated a correlation between the state of health and the following independent variables: age, life quality, social position and financial situation (C-Pearson's coefficient over 0,300); a statistically significant yet weak correlation was recorded for gender, household size, place of residence and amount of free time. The conducted analysis proved the existence of a huge gap between state of health of the population in urban and rural areas. In order to eliminate unfavourable differences in the state iof health among the residents of Eastern Poland, and provide equal sustainable development in urban and rural areas of the examined areas, special preventive programmes aimed at the residents of peripheral, marginalized rural areas should be implemented. In these programmes, attention should be paid to preventive measures, early diagnosis of basic civilization and social diseases, and better accessibility to medical services for the residents.

What is urban environmental stewardship? Constructing a practitioner-derived framework

Treesearch

M. Romolini; W. Brinkley; K.L. Wolf

2012-01-01

Agencies and organizations deploy various strategies in response to environmental challenges, including the formulation of policy, programs, and regulations. Citizen-based environmental stewardship is increasingly seen as an innovative and important approach to improving and conserving landscape health. A new research focus on the stewardship of urban natural resources...

Spatiotemporal Discordance in Five Common Measures of Rurality for US Counties and Applications for Health Disparities Research in Older Adults.

PubMed

Cohen, Steven A; Kelley, Lauren; Bell, Allison E

2015-01-01

Rural populations face numerous barriers to health, including poorer health care infrastructure, access to care, and other sociodemographic factors largely associated with rurality. Multiple measures of rurality used in the biomedical and public health literature can help assess rural-urban health disparities and may impact the observed associations between rurality and health. Furthermore, understanding what makes a place truly "rural" versus "urban" may vary from region to region in the US. The objectives of this study are to compare and contrast five common measures of rurality and determine how well-correlated these measures are at the national, regional, and divisional level, as well as to assess patterns in the correlations between the prevalence of obesity in the population aged 60+ and each of the five measures of rurality at the regional and divisional level. Five measures of rurality were abstracted from the US Census and US Department of Agriculture (USDA) to characterize US counties. Obesity data in the population aged 60+ were abstracted from the Behavioral Risk Factor Surveillance System (BRFSS). Spearman's rank correlations were used to quantify the associations among the five rurality measurements at the national, regional, and divisional level, as defined by the US Census Bureau. Geographic information systems were used to visually illustrate temporal, spatial, and regional variability. Overall, Spearman's rank correlations among the five measures ranged from 0.521 (percent urban-urban influence code) to 0.917 (rural-urban continuum code-urban influence code). Notable discrepancies existed in these associations by Census region and by division. The associations between measures of rurality and obesity in the 60+ population varied by rurality measure used and by region. This study is among the first to systematically assess the spatial, temporal, and regional differences and similarities among five commonly used measures of rurality in the US. There are important, quantifiable distinctions in defining what it means to be a rural county depending on both the geographic region and the measurement used. These findings highlight the importance of developing and selecting an appropriate rurality metric in health research.

Assessment and management of human health risk from toxic metals and polycyclic aromatic hydrocarbons in urban stormwater arising from anthropogenic activities and traffic congestion.

PubMed

Ma, Yukun; Liu, An; Egodawatta, Prasanna; McGree, James; Goonetilleke, Ashantha

2017-02-01

Toxic metals (TMs) and polycyclic aromatic hydrocarbons (PAHs) in urban stormwater pose risk to human health, thereby constraining its reuse potential. Based on the hypothesis that stormwater quality is primarily influenced by anthropogenic activities and traffic congestion, the primary focus of the research study was to analyse the impacts on human health risk from TMs and PAHs in urban stormwater and thereby develop a quantitative risk assessment model. The study found that anthropogenic activities and traffic congestion exert influence on the risk posed by TMs and PAHs in stormwater from commercial and residential areas. Motor vehicle related businesses (FVS) and traffic congestion (TC) were identified as two parameters which need to be included as independent variables to improve the model. Based on the study outcomes, approaches for mitigating the risk associated with TMs and PAHs in urban stormwater are discussed. Additionally, a roadmap is presented for the assessment and management of the risk arising from these pollutants. The study outcomes are expected to contribute to reducing the human health risk associated urban stormwater pollution and thereby enhance its reuse potential. Copyright © 2016 Elsevier B.V. All rights reserved.

EnviroAtlas Connects Urban Ecosystem Services and Human ...

EPA Pesticide Factsheets

Ecosystem services in urban areas can improve public health and well-being by mitigating natural and anthropogenic pollution, and by promoting healthy lifestyles that include engagement with nature and enhanced opportunities for physical activity and social interaction. EPA’s EnviroAtlas online mapping tool identifies urban environmental features linked in the scientific and medical literature to specific aspects of public health and well-being. EnviroAtlas researchers have synthesized newly-generated one-meter resolution landcover data, downscaled census population data, and other existing datasets such as roads and parks. Resulting geospatial metrics represent health-related indicators of urban ecosystem services supply and demand by census block-group and finer scales. EnviroAtlas maps include percent of the population with limited window views of trees, tree cover along walkable roads, overall neighborhood green space, and proximity to parks. Demographic data can be overlaid to perform analyses of disproportionate distribution of urban ecosystem services across population groups. Together with the Eco-Health Relationship Browser, EnviroAtlas data can be linked to numerous aspects of public health and well-being including school performance, physical fitness, social capital, and longevity. EnviroAtlas maps have been developed using consistent methods to allow for comparisons between neighborhoods and across multiple U.S. communities. To feature eco-heal

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

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.

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.

Editorial Research Reports on Health Topics.

ERIC Educational Resources Information Center

Dickinson, William B., Jr., Ed.

Nine reports published in this volume reflect the link between public health and national power. Not only the health problems of underdeveloped nations must be considered, but also the health problems of industrially advanced societies, those peculiar to life in an increasingly urban setting. The dilemmas posed by gains in medical science are…

It Takes a Village to Deliver and Test Child and Family-Focused Services

ERIC Educational Resources Information Center

McKay, Mary M.; Gopalan, Geetha; Franco, Lydia M.; Kalogerogiannis, Kosta; Umpierre, Mari; Olshtain-Mann, Orly; Bannon, William; Elwyn, Laura; Goldstein, Leah

2010-01-01

Objectives: The purpose of this article is to highlight the benefits of collaboration in child focused mental health services research. Method: Three unique research projects are described. These projects address the mental health needs of vulnerable, urban, minority children and their families. In each one, service delivery was codesigned,…

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.

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.

ARC3.2 Summary for City Leaders Climate Change and Cities: Second Assessment Report of the Urban Climate Change Research Network

NASA Technical Reports Server (NTRS)

Rosenzweig, C.; Solecki, W.; Romero-Lankao, P.; Mehrotra, S.; Dhakal, S.; Bowman, T.; Ibrahim, S. Ali

2015-01-01

ARC3.2 presents a broad synthesis of the latest scientific research on climate change and cities. Mitigation and adaptation climate actions of 100 cities are documented throughout the 16 chapters, as well as online through the ARC3.2 Case Study Docking Station. Pathways to Urban Transformation, Major Findings, and Key Messages are highlighted here in the ARC3.2 Summary for City Leaders. These sections lay out what cities need to do achieve their potential as leaders of climate change solutions. UCCRN Regional Hubs in Europe, Latin America, Africa, Australia and Asia will share ARC3.2 findings with local city leaders and researchers. The ARC3.2 Summary for City Leaders synthesizes Major Findings and Key Messages on urban climate science, disasters and risks, urban planning and design, mitigation and adaptation, equity and environmental justice, economics and finance, the private sector, urban ecosystems, urban coastal zones, public health, housing and informal settlements, energy, water, transportation, solid waste, and governance. These were based on climate trends and future projections for 100 cities around the world.

Health/Service Providers' Perspectives on Barriers to Healthy Weight Gain and Physical Activity in Pregnant, Urban First Nations Women.

PubMed

Darroch, Francine E; Giles, Audrey R

2016-01-01

The purpose of this article is to examine health/service providers' perspectives of barriers to healthy weight gain and physical activity for urban, pregnant First Nations women in Ottawa, Canada. Through the use of semi-structured interviews, we explored 15 health/service providers' perspectives on the complex barriers their clients face. By using a postcolonial feminist lens and a social determinants of health framework, we identified three social determinants of health that the health/service providers believed to have the greatest influence on their clients' weight gain and physical activity during pregnancy: poverty, education, and colonialism. Our findings are then contextualized within existing Statistics Canada and the Ottawa Neighbourhood Study data. We found that health/service providers are in a position to challenge colonial relations of power. We conclude by urging health/service providers, researchers, and policymakers alike to take into consideration the ways in which these social determinants of health and their often synergistic effects affect urban First Nations women during pregnancy. © The Author(s) 2015.

Identifying environmental health priorities in underserved populations: a study of rural versus urban communities

PubMed Central

Bernhard, M.C.; Evans, M.B.; Kent, S.T.; Johnson, E.; Threadgill, S.L.; Tyson, S.; Becker, S.M.; Gohlke, J.M.

2013-01-01

Objectives Understanding and effectively addressing persistent health disparities in minority communities requires a clear picture of members’ concerns and priorities. This study was intended to engage residents in urban and rural communities in order to identify environmental health priorities. Specific emphasis was placed on how the communities defined the term environment, their perceptions of environmental exposures as affecting their health, specific priorities in their communities, and differences in urban versus rural populations. Study design A community-engaged approach was used to develop and implement focus groups and compare environmental health priorities in urban versus rural communities. Methods A total of eight focus groups were conducted: four in rural and four in urban communities. Topics included defining the term environment, how the environment may affect health, and environmental priorities within their communities, using both open discussion and a predefined list. Data were analysed both qualitatively and quantitatively to identify patterns and trends. Results There were important areas of overlap in priorities between urban and rural communities; both emphasized the importance of the social environment and shared a concern over air pollution from industrial sources. In contrast, for urban focus groups, abandoned houses and their social and physical sequelae were a high priority while concerns about adequate sewer and water services and road maintenance were high priorities in rural communities. Conclusions This study was able to identify environmental health priorities in urban versus rural minority communities. In contrast to some previous risk perception research, the results of this study suggest prioritization of tangible, known risks in everyday life instead of rare, disaster-related events, even in communities that have recently experienced devastating damage from tornadoes. The findings can help inform future efforts to study, understand and effectively address environmental issues, and are particularly relevant to developing effective community-based strategies in vulnerable populations. PMID:24239281

Health impacts of frequent heavy automobile traffic on children and adolescents.

PubMed

Akpan, Akpan I

2004-01-01

This paper assesses the extent to which particulate, elemental and organic carbon emissions from heavy traffic in urban city roads affect the health of children and the adolescent health. Although the health effects of exposures may be cumulative, it is in the adolescence that the manifestations are realized. This paper therefore, assesses the best way forward for monitoring and preventing the environmental health impacts of heavy traffic on children and adolescents who live within the vicinity of urban city transportation systems. Major urban cities such as Houston, New York, and California are cited as examples of cities where health-related problems have already been reported. The particulate, elemental and organic carbon emissions are reviewed as the sources by which heavy traffic and the hazardous chemical emissions affect the health of the populace. The role of accessory loading and engine speed on idling emissions in direct health risks of children and adolescents is evaluated. The association of particulate, elemental, and organic carbon emission with respiratory effects (including, allergies and asthma), and the related behavior problems in children and the adolescents are discussed. The best strategies in preventing the effects of heavy traffic in the urban cities are suggested by introducing new effective monitoring techniques and exposure assessment methods. It is visualized that a more comprehensive research is needed to develop robust regulatory systems that would control the efficiency of automobiles and prevent the adverse health effects relating to heavy traffics in urban city roads. Strong city environmental health authorities-community partnerships relevant to exposure information should be encouraged.

Exposing some important barriers to health care access in the rural USA.

PubMed

Douthit, N; Kiv, S; Dwolatzky, T; Biswas, S

2015-06-01

To review research published before and after the passage of the Patient Protection and Affordable Care Act (2010) examining barriers in seeking or accessing health care in rural populations in the USA. This literature review was based on a comprehensive search for all literature researching rural health care provision and access in the USA. Pubmed, Proquest Allied Nursing and Health Literature, National Rural Health Association (NRHA) Resource Center and Google Scholar databases were searched using the Medical Subject Headings (MeSH) 'Rural Health Services' and 'Rural Health.' MeSH subtitle headings used were 'USA,' 'utilization,' 'trends' and 'supply and distribution.' Keywords added to the search parameters were 'access,' 'rural' and 'health care.' Searches in Google Scholar employed the phrases 'health care disparities in the USA,' inequalities in 'health care in the USA,' 'health care in rural USA' and 'access to health care in rural USA.' After eliminating non-relevant articles, 34 articles were included. Significant differences in health care access between rural and urban areas exist. Reluctance to seek health care in rural areas was based on cultural and financial constraints, often compounded by a scarcity of services, a lack of trained physicians, insufficient public transport, and poor availability of broadband internet services. Rural residents were found to have poorer health, with rural areas having difficulty in attracting and retaining physicians, and maintaining health services on a par with their urban counterparts. Rural and urban health care disparities require an ongoing program of reform with the aim to improve the provision of services, promote recruitment, training and career development of rural health care professionals, increase comprehensive health insurance coverage and engage rural residents and healthcare providers in health promotion. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The relationships between urban parks, residents' physical activity, and mental health benefits: A case study from Beijing, China.

PubMed

Liu, Hongxiao; Li, Feng; Li, Juanyong; Zhang, Yuyang

2017-04-01

The role of urban parks in improving public health has been analyzed in the context of urban design in developed countries, but has seldom been considered in developing countries such as China. Previous studies have found positive correlations between parks and residents' physical activity and mental health status. In this study, we conducted a questionnaire survey to investigate respondents' physical activity status and its relationship with urban parks. The impact of different activities engaged in during park use on positive mental health was examined. The average physical activity level of the sample was 92.7 min of moderate to vigorous physical activity per day. Park users were more active in all forms of physical activity, except transport walking, than non-users. The presence of a park within 500 m from home and park use were significantly associated with total physical activity. Physical activity in parks significantly restored visitors' moods and energy levels, and interaction with nature brought mental health benefits in terms of relaxation and self-perceived confidence. Overall, this study found a positive correlation of urban parks with public physical activity and positive mental health benefits. However, further research is needed to improve the understanding of this relationship in the context of China. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Wisconsin Network for Health Research (WiNHR): a statewide, collaborative, multi-disciplinary, research group.

PubMed

Bailey, Howard; Agger, William; Baumgardner, Dennis; Burmester, James K; Cisler, Ron A; Evertsen, Jennifer; Glurich, Ingrid; Hartman, David; Yale, Steven H; DeMets, David

2009-12-01

In response to the goals of the Wisconsin Partnership Program and the National Institutes of Health (NIH) Initiatives to Improve Healthcare, the Wisconsin Network for Health Research (WiNHR) was formed. As a collaborative, multi-disciplinary statewide research network, WiNHR encourages and fosters the discovery and application of scientific knowledge for researchers and practitioners throughout Wisconsin. The 4 founding institutions--Aurora Health Care/Center for Urban Population Health (CUPH), Gundersen Lutheran Medical Foundation, Marshfield Clinic Research Foundation, and the University of Wisconsin-Madison--representing geographically diverse areas of the state, are optimistic and committed to WiNHR's success. This optimism is based on the relevance of its goals to public health, the quality of statewide health care research, and, most importantly, the residents of Wisconsin who recognize the value of health research.

The Wisconsin Network for Health Research (WiNHR): A Statewide, Collaborative, Multi-disciplinary, Research Group

PubMed Central

Bailey, Howard; Agger, William; Baumgardner, Dennis; Burmester, James K.; Cisler, Ron A.; Evertsen, Jennifer; Glurich, Ingrid; Hartman, David; Yale, Steven H.; DeMets, David

2010-01-01

In response to the goals of the Wisconsin Partnership Program and the National Institutes of Health (NIH) Initiatives to Improve Healthcare, the Wisconsin Network for Health Research (WiNHR) was formed. As a collaborative, multi-disciplinary statewide research network, WiNHR encourages and fosters the discovery and application of scientific knowledge for researchers and practitioners throughout Wisconsin. The 4 founding institutions—Aurora Health Care/Center for Urban Population Health (CUPH), Gundersen Lutheran Medical Foundation, Marshfield Clinic Research Foundation, and the University of Wisconsin-Madison—representing geographically diverse areas of the state, are optimistic and committed to WiNHR’s success. This optimism is based on the relevance of its goals to public health, the quality of statewide health care research, and, most importantly, the residents of Wisconsin who recognize the value of health research. PMID:20131687

Decomposing the gap in childhood undernutrition between poor and non-poor in urban India, 2005-06.

PubMed

Kumar, Abhishek; Singh, Aditya

2013-01-01

Despite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India. We used cross-sectional data from the third round of the National Family Health Survey conducted during 2005-06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder-Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India. Considerable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005-06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty. The findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition.

Decomposing the Gap in Childhood Undernutrition between Poor and Non–Poor in Urban India, 2005–06

PubMed Central

Kumar, Abhishek; Singh, Aditya

2013-01-01

Background Despite the growing evidence from other developing countries, intra-urban inequality in childhood undernutrition is poorly researched in India. Additionally, the factors contributing to the poor/non-poor gap in childhood undernutrition have not been explored. This study aims to quantify the contribution of factors that explain the poor/non-poor gap in underweight, stunting, and wasting among children aged less than five years in urban India. Methods We used cross-sectional data from the third round of the National Family Health Survey conducted during 2005–06. Descriptive statistics were used to understand the gap in childhood undernutrition between the urban poor and non-poor, and across the selected covariates. Blinder–Oaxaca decomposition technique was used to explain the factors contributing to the average gap in undernutrition between poor and non-poor children in urban India. Result Considerable proportions of urban children were found to be underweight (33%), stunted (40%), and wasted (17%) in 2005–06. The undernutrition gap between the poor and non-poor was stark in urban India. For all the three indicators, the main contributing factors were underutilization of health care services, poor body mass index of the mothers, and lower level of parental education among those living in poverty. Conclusions The findings indicate that children belonging to poor households are undernourished due to limited use of health care services, poor health of mothers, and poor educational status of their parents. Based on the findings the study suggests that improving the public services such as basic health care and the education level of the mothers among urban poor can ameliorate the negative impact of poverty on childhood undernutrition. PMID:23734231

Methods for successful follow-up of elusive urban populations: an ethnographic approach with homeless men.

PubMed Central

Conover, S.; Berkman, A.; Gheith, A.; Jahiel, R.; Stanley, D.; Geller, P. A.; Valencia, E.; Susser, E.

1997-01-01

Public health is paying increasing attention to elusive urban populations such as the homeless, street drug users, and illegal immigrants. Yet, valid data on the health of these populations remain scarce; longitudinal research, in particular, has been hampered by poor follow-up rates. This paper reports on the follow-up methods used in two randomized clinical trials among one such population, namely, homeless men with mental illness. Each of the two trials achieved virtually complete follow-up over 18 months. The authors describe the ethnographic approach to follow-up used in these trials and elaborate its application to four components of the follow-up: training interviewers, tracking participants, administering the research office, and conducting assessments. The ethnographic follow-up method is adaptable to other studies and other settings, and may provide a replicable model for achieving high follow-up rates in urban epidemiologic studies. PMID:9211004

Rural tobacco use across the United States: How rural and urban areas differ, broken down by census regions and divisions.

PubMed

Roberts, Megan E; Doogan, Nathan J; Kurti, Allison N; Redner, Ryan; Gaalema, Diann E; Stanton, Cassandra A; White, Thomas J; Higgins, Stephen T

2016-05-01

This project compared urban/rural differences in tobacco use, and examined how such differences vary across regions/divisions of the U.S. Using pooled 2012-2013 data from the National Survey on Drug Use and Health (NSDUH), we obtained weighted prevalence estimates for the use of cigarettes, menthol cigarettes, chewing tobacco, snuff, cigars, and pipes. NSDUH also provides information on participants' residence: rural vs. urban, and Census region and division. Overall, use of cigarettes, chew, and snuff were higher in rural, compared to urban areas. Across all tobacco products, urban/rural differences were particularly pronounced in certain divisions (e.g., the South Atlantic). Effects did not appear to be fully explained by differences in poverty. Going beyond previous research, these findings show that urban/rural differences vary across different types of tobacco products, as well as by division of the country. Results underscore the need for regulatory efforts that will reduce health disparities. Copyright © 2016 Elsevier Ltd. All rights reserved.

Rural Tobacco Use across the United States: How Rural and Urban Areas Differ, Broken Down by Census Regions and Divisions

PubMed Central

Roberts, Megan E.; Doogan, Nathan J.; Kurti, Allison N.; Redner, Ryan; Gaalema, Diann E.; Stanton, Cassandra A.; White, Thomas J.; Higgins, Stephen T.

2016-01-01

This project compared urban/rural differences in tobacco use, and examined how such differences vary across regions/divisions of the U.S. Using pooled 2012–2013 data from the National Survey on Drug Use and Health (NSDUH), we obtained weighted prevalence estimates for the use of cigarettes, menthol cigarettes, chewing tobacco, snuff, cigars, and pipes. NSDUH also provides information on participants’ residence: rural vs. urban, and Census region and division. Overall, use of cigarettes, chew, and snuff were higher in rural, compared to urban areas. Across all tobacco products, urban/rural differences were particularly pronounced in certain divisions (e.g., the South Atlantic). Effects did not appear to be fully explained by differences in poverty. Going beyond previous research, these findings show that urban/rural differences vary across different types of tobacco products, as well as by division of the country. Results underscore the need for regulatory efforts that will reduce health disparities. PMID:27107746

Defining the urban area for cross national comparison of health indicators: the EURO-URHIS 2 boundary study.

PubMed

Higgerson, James; Birt, Christopher A; van Ameijden, Erik; Verma, Arpana

2017-05-01

Despite much research focusing on the impact of the city condition upon health, there still remains a lack of consensus over what constitutes an urban area (UA). This study was conducted to establish comparable boundaries for the UAs participating in EURO-URHIS 2, and to test whether the sample reflected the heterogeneity of urban living. Key UA contacts ( n = 28) completed a cross-sectional questionnaire, which included where available comparison between Urban Audit city and larger urban zone (LUZ) boundaries and public health administration areas (PHAAs). Additionally, broad health and demographic indicators were sought to test for heterogeneity of the EURO-URHIS 2 sample. Urban Audit city boundaries were found to be suitable for data collection in 100% ( n = 21) of UAs where Urban Audit data were available. The remainder ( n = 7) identified PHAA boundaries akin to the 'city' level. Heterogeneity was observed in the sample for population size and infant mortality rate. Heterogeneity could not be established for male and female life expectancy. This study was able to establish comparable boundaries for EURO-URHIS 2 data collection, with the 'city' area being selected for data collection. The homogeneity of life expectancy indicators was reflective of sub-regional similarities in life expectancy, whilst population estimates and rates of infant mortality indicated the presence of heterogeneity within the sample. Future work would trial these methods with a larger number of indicators and for a larger number of UAs. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Sleep and dietary habits in the urban environment: the role of chrono-nutrition.

PubMed

Pot, Gerda K

2017-10-25

The urban environment has changed vastly over past decades, which also has had an impact on our sleep and dietary patterns and possibly health outcomes. Some studies have shown that sleep duration and sleep quality has declined over past decades, especially in children. In parallel, our lifestyle and dietary patterns have also changed including more shift work, more meals outside the home or family setting and more irregular eating patterns, including breakfast skipping and late-night eating. This new area of research in nutritional sciences studying the impact of the timing of eating on health outcomes is called chrono-nutrition, and combines elements from nutritional research with chrono-biology. The objectives of this paper were to discuss secular trends in sleep patterns and related dietary patterns, introduce basic concepts and mechanisms of chrono-nutrition and discuss the evidence for the importance of sleep and chrono-nutrition in relation to health outcomes. Overall, chrono-nutrition could mediate the effects between sleep, diet and urbanisation, and more research is needed to elucidate the importance of chrono-nutrition for metabolic health and its impact on public health.

Poverty and palliative care in the US: issues facing the urban poor.

PubMed

Hughes, Anne

2005-01-01

Poverty is a significant public health and social problem in the US. The urban poor living with life-limiting illnesses are a particularly vulnerable population. The literature related to the experiences of the urban poor at the end of life is sparse. Most relates to the experiences of patients with cancer. The purpose of this literature review is to describe the problem of poverty in the US, to identify challenges in providing palliative care to the urban poor, and lastly, to articulate implications for nursing practice and nursing research.

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.

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.

New to New York: Ecological and Psychological Predictors of Health Among Recently Arrived Young Adult Gay and Bisexual Urban Migrants.

PubMed

Pachankis, John E; Eldahan, Adam I; Golub, Sarit A

2016-10-01

Young gay and bisexual men might move to urban enclaves to escape homophobic environments and achieve greater sexual and social freedom, yet little is known about the health risks that these young migrants face. Drawing on recent qualitative depictions of gay and bisexual men's urban ecologies and psychological research on motivation and goal pursuit, we investigated migration-related motivations, experiences, health risks, and their associations among young gay and bisexual men in New York City. Gay and bisexual men (n = 273; ages 18-29) who had moved to New York City within the past 12 months completed an online survey regarding their hometowns, new urban experiences, migration motivations, and health risks. Not having a college degree, HIV infection, hometown stigma, within-US migration, and moving to outside a gay-dense neighborhood were associated with moving to escape stress; hometown structural stigma and domestic migration were associated with moving for opportunity. Migrating from larger US-based hometowns, having recently arrived, and moving for opportunity predicted HIV transmission risk. Social isolation predicted lower drug use but more mental health problems. Higher income predicted lower HIV and mental health risk but higher alcohol risk. Hometown interpersonal discrimination predicted all health risks, but hometown structural stigma protected against drug risk. Findings offer a comprehensive picture of young gay and bisexual male migrants' experiences and health risks and help build a theory of high-risk migration. Results can inform structural- and individual-level interventions to support the health of this sizeable and vulnerable segment of the urban population.

Health Status and Working Condition of Migrant Workers: Major Public Health Problems

PubMed Central

Bener, Abdulbari

2017-01-01

Background: Very little research and survey have been performed on the occupational health, hazards, and working condition of urban and rural of workers in Qatar. The aim of the current study is to identify the health status, lifestyle condition, working-related problems, and accidents experienced by Indian subcontinental migrants (ISCM) in Qatar and their access to health-care facilities. Methods: This is a cross-sectional study based on a representative sample of 1186 workers and study covering sociodemographic characteristics, medical conditions, and health-seeking behaviors and personal experience. Results: There were statistically significant differences between semi-urban and urban migrant workers in terms of educational, occupation, income, working hours, and accommodation type (P < 0.001). Furthermore, there were statistically significant differences between migrant workers in terms of body mass index, delay in receiving salary, the right to medical insurance and sick day entitlement, cigarettes and shisha smoking, amenities, having on-site safety measure, and sleeping hours (P < 0.01). Moreover, there were statistically significant differences between semi-urban and urban migrant workers in terms of pain, cardiopulmonary, gastrointestinal, and pseudoneurologic and medical symptoms (P < 0.01). Multiple logistic regression was used for predictors’ health problems in migrant workers such as the absence of drinking water, tap water availability, safety facility tools, occupational status, shisha smoking, toilet facility, working hours, and accommodation type were considered the strong predictors. Conclusions: The current study revealed that there is a lack of insufficient information for the migrants about their lifestyle, medical conditions, health risks, injury, and rights privilege in relation to legal working condition and health services. PMID:28966757

Health Status and Working Condition of Migrant Workers: Major Public Health Problems.

PubMed

Bener, Abdulbari

2017-01-01

Very little research and survey have been performed on the occupational health, hazards, and working condition of urban and rural of workers in Qatar. The aim of the current study is to identify the health status, lifestyle condition, working-related problems, and accidents experienced by Indian subcontinental migrants (ISCM) in Qatar and their access to health-care facilities. This is a cross-sectional study based on a representative sample of 1186 workers and study covering sociodemographic characteristics, medical conditions, and health-seeking behaviors and personal experience. There were statistically significant differences between semi-urban and urban migrant workers in terms of educational, occupation, income, working hours, and accommodation type ( P < 0.001). Furthermore, there were statistically significant differences between migrant workers in terms of body mass index, delay in receiving salary, the right to medical insurance and sick day entitlement, cigarettes and shisha smoking, amenities, having on-site safety measure, and sleeping hours ( P < 0.01). Moreover, there were statistically significant differences between semi-urban and urban migrant workers in terms of pain, cardiopulmonary, gastrointestinal, and pseudoneurologic and medical symptoms ( P < 0.01). Multiple logistic regression was used for predictors' health problems in migrant workers such as the absence of drinking water, tap water availability, safety facility tools, occupational status, shisha smoking, toilet facility, working hours, and accommodation type were considered the strong predictors. The current study revealed that there is a lack of insufficient information for the migrants about their lifestyle, medical conditions, health risks, injury, and rights privilege in relation to legal working condition and health services.

Free Primary Education Policy and Pupil School Mobility in Urban Kenya

ERIC Educational Resources Information Center

Oketch, Moses; Mutisya, Maurice; Ngware, Moses; Ezeh, Alex C.; Epari, Charles

2010-01-01

This paper examines pupil school mobility in urban Kenya using African Population and Health Research Centre (APHRC) household survey data which contain information on pupil transfers between schools. The aim is to identify which school characteristics attract the greatest demand for incoming transfers. The analysis reveals that there are frequent…

Using Social Media to Identify Sources of Healthy Food in Urban Neighborhoods.

PubMed

Gomez-Lopez, Iris N; Clarke, Philippa; Hill, Alex B; Romero, Daniel M; Goodspeed, Robert; Berrocal, Veronica J; Vinod Vydiswaran, V G; Veinot, Tiffany C

2017-06-01

An established body of research has used secondary data sources (such as proprietary business databases) to demonstrate the importance of the neighborhood food environment for multiple health outcomes. However, documenting food availability using secondary sources in low-income urban neighborhoods can be particularly challenging since small businesses play a crucial role in food availability. These small businesses are typically underrepresented in national databases, which rely on secondary sources to develop data for marketing purposes. Using social media and other crowdsourced data to account for these smaller businesses holds promise, but the quality of these data remains unknown. This paper compares the quality of full-line grocery store information from Yelp, a crowdsourced content service, to a "ground truth" data set (Detroit Food Map) and a commercially-available dataset (Reference USA) for the greater Detroit area. Results suggest that Yelp is more accurate than Reference USA in identifying healthy food stores in urban areas. Researchers investigating the relationship between the nutrition environment and health may consider Yelp as a reliable and valid source for identifying sources of healthy food in urban environments.

Sustainability in urban water resources management - some notes from the field

NASA Astrophysics Data System (ADS)

Shuster, W.; Garmestani, A.; Green, O. O.

2014-12-01

Urban development has radically transformed landscapes, and along with it, how our cities and suburbs cycle energy and water. One unfortunate outcome of urbanization is the production of massive volumes of uncontrolled runoff volume. Our civic infrastructure is sometimes marginally capable of handling even dry-weather fluxes without wastewater system overflows, much less the challenges of wet-weather events. The predominance of runoff volume in urban water balance has had serious ramifications for regulatory activity, municipal financial matters, and public health. In the interest of protecting human health and the environment, my group's research has primarily addressed the integration of social equity, economic stabilization, and environmental management to underpin the development of sustainable urban water cycles. In this talk, I will present on: 1) the Shepherd Creek Stormwater Management project wherein an economic incentive was used to recruit citizen stormwater managers and distribute parcel-level, green infrastructure-based stormwater control measures; and 2) our urban soil pedologic-hydrologic assessment protocol that we use as a way of understanding the capacity for urban soils to provide ecosystem services, and in cities representing each of the major soil orders.

Archives of Environmental Health, Volume 18 Number 4. Ninth AMA Air Pollution Medical Research Conference, Denver, July 22-24, 1968.

ERIC Educational Resources Information Center

Barton, Frank

Papers read before the Ninth American Medical Association (AMA) Air Pollution Medical Research Conference, Denver, Colorado, July 22-24, 1968, are presented in this document. Topics deal with the relationship and effects of atmospheric pollution to respiratory diseases, epidemiology, human physiological reactions, urban morbidity, health of school…

A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India.

PubMed

Travasso, Sandra Mary; Rajaraman, Divya; Heymann, Sally Jody

2014-02-07

Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated with negative mental health amongst specific population groups in order to ensure greater impact.

A qualitative study of factors affecting mental health amongst low-income working mothers in Bangalore, India

PubMed Central

2014-01-01

Background Low-income urban working mothers face many challenges in their domestic, environmental, and working conditions that may affect their mental health. In India, a high prevalence of mental health disorders has been recorded in young women, but there has been little research to examine the factors that affect their mental health at home and work. Methods Through a primarily qualitative approach, we studied the relationship between work, caring for family, spousal support, stress relief strategies and mental health amongst forty eight low-income working mothers residing in urban slums across Bangalore, India. Participants were construction workers, domestic workers, factory workers and fruit and vegetable street vendors. Qualitative data analysis themes included state of mental health, factors that affected mental health positively or negatively, manifestations and consequences of stress and depression, and stress mitigators. Results Even in our small sample of women, we found evidence of extreme depression, including suicidal ideation and attempted suicide. Women who have an alcoholic and/or abusive husband, experience intimate partner violence, are raising children with special needs, and lack adequate support for child care appear to be more susceptible to severe and prolonged periods of depression and suicide attempts. Factors that pointed towards reduced anxiety and depression were social support from family, friends and colleagues and fulfilment from work. Conclusion This qualitative study raises concerns that low-income working mothers in urban areas in India are at high risk for depression, and identifies common factors that create and mitigate stress in this population group. We discuss implications of the findings for supporting the mental health of urban working women in the Indian context. The development of the national mental health policy in India and its subsequent implementation should draw on existing research documenting factors associated with negative mental health amongst specific population groups in order to ensure greater impact. PMID:24502531

Healthy urban environments for children and young people: A systematic review of intervention studies.

PubMed

Audrey, Suzanne; Batista-Ferrer, Harriet

2015-11-01

This systematic review collates, and presents as a narrative synthesis, evidence from interventions which included changes to the urban environment and reported at least one health behaviour or outcome for children and young people. Following a comprehensive search of six databases, 33 primary studies relating to 27 urban environment interventions were included. The majority of interventions related to active travel. Others included park and playground renovations, road traffic safety, and multi-component community-based initiatives. Public health evidence for effectiveness of such interventions is often weak because study designs tend to be opportunistic, non-randomised, use subjective outcome measures, and do not incorporate follow-up of study participants. However, there is some evidence of potential health benefits to children and young people from urban environment interventions relating to road safety and active travel, with evidence of promise for a multi-component obesity prevention initiative. Future research requires more robust study designs incorporating objective outcome measures. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

Infectious Diseases, Urbanization and Climate Change: Challenges in Future China.

PubMed

Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

2015-09-07

China is one of the largest countries in the world with nearly 20% of the world's population. There have been significant improvements in economy, education and technology over the last three decades. Due to substantial investments from all levels of government, the public health system in China has been improved since the 2003 severe acute respiratory syndrome (SARS) outbreak. However, infectious diseases still remain a major population health issue and this may be exacerbated by rapid urbanization and unprecedented impacts of climate change. This commentary aims to explore China's current capacity to manage infectious diseases which impair population health. It discusses the existing disease surveillance system and underscores the critical importance of strengthening the system. It also explores how the growing migrant population, dramatic changes in the natural landscape following rapid urbanization, and changing climatic conditions can contribute to the emergence and re-emergence of infectious disease. Continuing research on infectious diseases, urbanization and climate change may inform the country's capacity to deal with emerging and re-emerging infectious diseases in the future.

Living under the influence: normalisation of alcohol consumption in our cities.

PubMed

Sureda, Xisca; Villalbí, Joan R; Espelt, Albert; Franco, Manuel

Harmful use of alcohol is one of the world's leading health risks. A positive association between certain characteristics of the urban environment and individual alcohol consumption has been documented in previous research. When developing a tool characterising the urban environment of alcohol in the cities of Barcelona and Madrid we observed that alcohol is ever present in our cities. Urban residents are constantly exposed to a wide variety of alcohol products, marketing and promotion and signs of alcohol consumption. In this field note, we reflect the normalisation of alcohol in urban environments. We highlight the need for further research to better understand attitudes and practices in relation to alcohol consumption. This type of urban studies is necessary to support policy interventions to prevent and control harmful alcohol use. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Emerging Forms of Climate Protection Governance: Urban Initiatives in the European Union

NASA Astrophysics Data System (ADS)

Rosenthal, J. K.; Brunner, E.

2006-12-01

Changes in climate patterns are expected to pose increasing challenges for cities in the following decades, with adverse impacts on urban populations currently stressed by poverty, health and economic inequities. Simultaneously, a strong global trend towards urbanization of poverty exists, with increased challenges for local governments to protect and sustain the well-being of growing cities. In the context of these two overarching trends, interdisciplinary research at the city scale is prioritized for understanding the social impacts of climate change and variability and for the evaluation of strategies in the built environment that might serve as adaptive and mitigative responses to climate change. Urban managers, and transnational networks of municipalities and non-state actors, have taken an increasingly active role in climate protection, through research, policies, programs and agreements on adaptation and mitigation strategies. Concerns for urban impacts of climate change include the potential increase in frequency and intensity of damaging extreme weather events, such as heat waves, hurricanes, heavy rainfall or drought, and coastal flooding and erosion, and potentially adverse impacts on infrastructure, energy systems, and public health. Higher average summertime temperatures in temperate zone cities are also associated with environmental and public health liabilities such as decreased air quality and increased peak electrical demand. We review municipal climate protection programs, generally categorized as approaches based on technological innovation (e.g., new materials); changes in behavior and public education (e.g., use of cooling centers); and improvements in urban design (e.g., zoning for mixed land-use; the use of water, vegetation and plazas to reduce the urban heat island effect). Climate protection initiatives in three European cities are assessed within the context of the global collective efforts enacted by the Kyoto Protocol and United Nations Framework Convention on Climate Change. Initiatives in Stockholm, London and Milan provide evidence that local actions are inevitable and of central importance to mitigate and adapt to the adverse impacts of climate change, the urban heat island effect, and extreme weather events.

Utilizing community-based participatory research to adapt a mental health intervention for African American emerging adults.

PubMed

Mance, Gishawn A; Mendelson, Tamar; Byrd, Benjamin; Jones, Jahon; Tandon, Darius

2010-01-01

Adapting mental health interventions to heighten their cultural and contextual appropriateness may be critical for engaging ethnic/racial groups that have been traditionally excluded or marginalized. Community-based participatory research (CBPR) is a collaborative research approach that highlights unique strengths and expertise of those involved. Although intervention adaptations have garnered much attention there is little previous work specifically describing the adaptation process of mental health interventions using CBPR. This article summarizes the use of a CBPR approach to adapt a mental health intervention for urban adolescents and young adults disconnected from school and work, a population at elevated risk for poor mental health owing to the presence of numerous chronic stressors. We describe the process undertaken to modify the content and delivery format of an evidence-based intervention. Unique challenges of working with urban African American adolescents and young adults in a job training program are highlighted. By incorporating principles of co-learning and shared responsibility, this partnership was able to achieve positive outcomes. Our experience suggests that a CBPR approach can be used effectively to adapt a mental health intervention in collaboration with African American adolescents and emerging adults in a job training program.

Kids in the city study: research design and methodology.

PubMed

Oliver, Melody; Witten, Karen; Kearns, Robin A; Mavoa, Suzanne; Badland, Hannah M; Carroll, Penelope; Drumheller, Chelsea; Tavae, Nicola; Asiasiga, Lanuola; Jelley, Su; Kaiwai, Hector; Opit, Simon; Lin, En-Yi Judy; Sweetsur, Paul; Barnes, Helen Moewaka; Mason, Nic; Ergler, Christina

2011-07-24

Physical activity is essential for optimal physical and psychological health but substantial declines in children's activity levels have occurred in New Zealand and internationally. Children's independent mobility (i.e., outdoor play and traveling to destinations unsupervised), an integral component of physical activity in childhood, has also declined radically in recent decades. Safety-conscious parenting practices, car reliance and auto-centric urban design have converged to produce children living increasingly sedentary lives. This research investigates how urban neighborhood environments can support or enable or restrict children's independent mobility, thereby influencing physical activity accumulation and participation in daily life. The study is located in six Auckland, New Zealand neighborhoods, diverse in terms of urban design attributes, particularly residential density. Participants comprise 160 children aged 9-11 years and their parents/caregivers. Objective measures (global positioning systems, accelerometers, geographical information systems, observational audits) assessed children's independent mobility and physical activity, neighborhood infrastructure, and streetscape attributes. Parent and child neighborhood perceptions and experiences were assessed using qualitative research methods. This study is one of the first internationally to examine the association of specific urban design attributes with child independent mobility. Using robust, appropriate, and best practice objective measures, this study provides robust epidemiological information regarding the relationships between the built environment and health outcomes for this population.

Kids in the city study: research design and methodology

PubMed Central

2011-01-01

Background Physical activity is essential for optimal physical and psychological health but substantial declines in children's activity levels have occurred in New Zealand and internationally. Children's independent mobility (i.e., outdoor play and traveling to destinations unsupervised), an integral component of physical activity in childhood, has also declined radically in recent decades. Safety-conscious parenting practices, car reliance and auto-centric urban design have converged to produce children living increasingly sedentary lives. This research investigates how urban neighborhood environments can support or enable or restrict children's independent mobility, thereby influencing physical activity accumulation and participation in daily life. Methods/Design The study is located in six Auckland, New Zealand neighborhoods, diverse in terms of urban design attributes, particularly residential density. Participants comprise 160 children aged 9-11 years and their parents/caregivers. Objective measures (global positioning systems, accelerometers, geographical information systems, observational audits) assessed children's independent mobility and physical activity, neighborhood infrastructure, and streetscape attributes. Parent and child neighborhood perceptions and experiences were assessed using qualitative research methods. Discussion This study is one of the first internationally to examine the association of specific urban design attributes with child independent mobility. Using robust, appropriate, and best practice objective measures, this study provides robust epidemiological information regarding the relationships between the built environment and health outcomes for this population. PMID:21781341

Fertility and Child Mortality in Urban West Africa: Leveraging geo-referenced data to move beyond the urban/rural dichotomy

PubMed Central

Corker, Jamaica

2016-01-01

Demographic research in sub-Saharan Africa (SSA) has long relied on a blunt urban/rural dichotomy that may obscure important inter-urban fertility and mortality differentials. This paper uses Demographic and Health Survey (DHS) geo-referenced data to look beyond the simple urban/rural division by spatially locating survey clusters along an urban continuum and producing estimates of fertility and child mortality by four city size categories in West Africa. Results show a gradient in urban characteristics and demographic outcomes: the largest cities are the most advantaged and smaller cities least advantaged with respect to access to urban amenities, lower fertility and under-5 survival rates. There is a difference in the patterns of fertility and under-five survival across urban categories, with fertility more linearly associated with city size while the only significant distinction for under-5 survival in urban areas is broadly between the larger and smaller cities. Notably, the small urban “satellite cities” that are adjacent to the largest cities have the most favorable outcomes of all categories. Although smaller urban areas have significantly lower fertility and child mortality than rural areas, in some cases this difference is nearly as large between the smallest and largest urban areas. These results are used to argue for the need to give greater consideration to employing an urban continuum in demographic research. PMID:28943812

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.

A citizen science campaign encouraging urban forest professionals to engage the public in the collection of tree phenological data

NASA Astrophysics Data System (ADS)

Clarke, K. C.

2009-12-01

There are growing concerns among leading national and local organizations about American scientific literacy, fundamental understanding of science, and the value of scientific research. These organizations, including the University Corporation for Atmospheric Research, have been at the forefront in addressing these concerns. In an effort to improve scientific literacy, research conducted by Sam Droege, among others, suggested using citizen science and public participation as instrumental methods to engage the public. Urban Tree Phenology (UTP), a project of Project BudBurst and the USDA Forest Service, is one such citizen science program that sought to engage the public, including the professionals and amateurs among them, in collecting urban tree phenophase data. UTP participants monitored and reported the stages of phenological events, such as First Leaf and Leaf Fall, of 24 native and cultivated urban tree species, using the steps shown in Figure 1. Data collected will support the long-term research of plant ecology, climate change, public health, urban heat islands on tree physiology, and urban tree management. UTP, using the architectures of online learning, has developed two instructional tutorials to assist data collection (Phase 1). The instructional tutorials were published online, in print and PowerPoint formats, at www.UrbanTreePhenology.com. By completing these tutorials, participants will gain the skills necessary to provide urban tree phenological data to national research databases via the Internet. Phase 2 will test and review the instructional materials developed, and in Phase 3, the administrators of UTP will distribute promotional materials to national research organizations and to participants of the Project BudBurst national citizen science campaign.

HEALTH EFFECTS AND CHARACTERIZATION OF URBAN AND RURAL COARSE PARTICULATEMATTER IN NORTHEASTERN COLORADO

EPA Science Inventory

The proposed research will contribute to our understanding of the health outcomes associated with CP and other air pollutants in a region of the country with relatively sparse monitoring data and few prior health effects studies. The work will allow comparison of responses in ...

The intersection of violence, substance use, depression, and STDs: testing of a syndemic pattern among patients attending an urban STD clinic.

PubMed

Senn, Theresa E; Carey, Michael P; Vanable, Peter A

2010-07-01

High rates of psychosocial and health problems have been identified among patients attending sexually transmitted disease (STD) clinics, who are disproportionately urban, have low income, and are racial/ethnic minorities. This study sought to determine whether these problems co-occurred and whether they indicated the presence of a syndemic. Patients (N = 1557, 46% female, 64% African American) attending an urban STD clinic completed a computerized survey assessing childhood sexual abuse (CSA), depressive symptoms, binge drinking, marijuana use, intimate partner violence (IPV), and sexual risk behavior. Medical records were reviewed to determine incident STD diagnosis. The psychosocial and health problems were interrelated. Endorsing more psychosocial problems was associated with a greater likelihood of having multiple sexual partners and STD diagnosis. Interactions between CSA and marijuana use and between CSA and IPV predicted STD diagnosis. Numerous psychosocial and health problems co-occur among urban STD clinic patients. There was some evidence of a syngergistic relationship (i.e., a syndemic) between these conditions, resulting in worsened sexual health outcomes. Health care needs to be multidisciplinary to address the multiple psychosocial and health problems faced by STD clinic patients. Research needs to identify factors that may underlie these comorbid conditions.

Increasing of Urban Radiation due to Climate Change and Reduction Strategy using Vegetation

NASA Astrophysics Data System (ADS)

Park, C.; Lee, D.; Heo, H. K.; Ahn, S.

2017-12-01

Urban Heat Island (UHI) which means urban air temperature is higher than suburban area is one of the most important environmental issues in Urban. High density of buildings and high ratio of impervious surfaces increases the radiation fluxes in urban canopy. Furthermore, climate change is expected to make UHI even more seriously in the future. Increased irradiation and air temperature cause high amount of short wave and long wave radiation, respectively. This increases net radiation negatively affects heat condition of pedestrian. UHI threatens citizen's health by increasing violence and heat related diseases. For this reason, understanding how much urban radiation will increase in the future, and exploring radiation reduction strategies is important for reducing UHI. In this research, we aim to reveal how the radiation flux in the urban canyon will change as the climate change and determine how much of urban vegetation will be needed to cover this degradation. The study area is a commercial district in Seoul where highly populated area. Due to the high density of buildings and lack of urban vegetation, this area has a poor thermal condition in summer. In this research, we simulate the radiation flux on the ground using multi-layer urban canopy model. Unlike conventionally used urban canopy model to simulate radiation transfer using vertically single layer, the multi-layer model we used here, enables to consider the vertical heterogeneous of buildings and urban vegetation. As a result, net radiation of urban ground will be increase 2.1 W/m² in the 2050s and 2.7 W/m² in the 2100s. And to prevent the increase of radiation, it is revealed that the urban vegetation should by increased by 10%. This research will be valuable in establishing greening planning as a strategy to reduce UHI effect.

Urban Youth Knowledge and Attitudes Regarding Lead Poisoning.

PubMed

Bogar, Sandra; Szabo, Aniko; Woodruff, Shane; Johnson, Sheri

2017-12-01

Environmental health literacy (EHL) is a promising and evolving field of research that could benefit from youth engagement. Yet studies focused on youths' environmental health awareness and concerns are limited. For example, although lead exposure remains a threat to youth development in urban environments, no published studies have measured urban youth's knowledge of lead poisoning. A CBPR partnership established a youth advisory council (YAC) who helped to design, interpret and disseminate a mixed methods study exploring environmental health perceptions among urban youths ages 10-18. Surveys assessed awareness, attitudes, and knowledge regarding lead poisoning and five environmental health issues determined by the YAC. Focus group questions further contextualized youths' lead knowledge and understanding of youths' environmental health concerns. A majority of youth could identify specific sources of lead exposure but had minimal knowledge of prevention strategies, and focus group data revealed misinformation regarding lead sources and consequences. Survey and focus group respondents' level of awareness and concern regarding YAC-selected EH issues was high in comparison to lead poisoning. In particular, job opportunities and police brutality were endorsed as both neighborhood concerns and priorities. Awareness and knowledge of environmental health issues among urban youth have not been well described. These findings reinforce the importance of addressing problems of local relevance. Moving forward, lead poisoning prevention education for youth and youth EHL partnerships may benefit from incorporating an ecological approach wherein connections to the social and economic context are made explicit.

Shaping Patient Education in Rural Hospitals: Learning from the Experiences of Patients

ERIC Educational Resources Information Center

Scheckel, Martha; Hedrick-Erickson, Jennifer; Teunis, Jamie; Deutsch, Ashley; Roers, Anna; Willging, Anne; Pittman, Kelly

2012-01-01

Patient education is a crucial aspect of nursing practice, but much of the research about it is quantitative and has been conducted in urban medical centers. These urban-based studies have limited utility for nurses working in rural hospitals where the populations they serve often have unique and challenging health contexts and cultures. Since…

Suicidality among Urban African American & Latino Youth. Data Trends #104

ERIC Educational Resources Information Center

Research and Training Center on Family Support and Children's Mental Health, 2004

2004-01-01

"Data Trends" reports present summaries of research on mental health services for children and adolescents and their families. The article summarized in this "Data Trends" presents the results of a survey investigation of the prevalence and predictors of suicidality among 879 urban adolescents. In the U. S., suicide is the third leading cause of…

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…

Exploring Rural Disparities in Medical Diagnoses Among Veterans With Transgender-related Diagnoses Utilizing Veterans Health Administration Care.

PubMed

Bukowski, Leigh A; Blosnich, John; Shipherd, Jillian C; Kauth, Michael R; Brown, George R; Gordon, Adam J

2017-09-01

Research shows transgender individuals experience pronounced health disparities compared with their nontransgender peers. Yet, there remains insufficient research about health differences within transgender populations. This study seeks to fill this gap by exploring how current urban/rural status is associated with lifetime diagnosis of mood disorder, alcohol dependence disorder, illicit drug abuse disorder, tobacco use, posttraumatic stress disorder, human immunodeficiency virus, and suicidal ideation or attempt among veterans with transgender-related diagnoses. This study used a retrospective review of The Department of Veterans Affairs (VA) administrative data for transgender patients who received VA care from 1997 through 2014. Transgender patients were defined as individuals that had a lifetime diagnosis of any of 4 International Classification of Diseases-9 diagnosis codes associated with transgender status. Independent multivariable logistic regression models were used to explore associations of rural status with medical conditions. Veterans with transgender-related diagnoses residing in small/isolated rural towns had increased odds of tobacco use disorder (adjusted odds ratio=1.39; 95% confidence intervals, 1.09-1.78) and posttraumatic stress disorder (adjusted odds ratio=1.33; 95% confidence intervals, 1.03-1.71) compared with their urban transgender peers. Urban/rural status was not significantly associated with other medical conditions of interest. This study contributes the first empirical investigations of how place of residence is associated with medical diagnoses among veterans with transgender-related diagnoses. The importance of place as a determinant of health is increasingly clear, but for veterans with transgender-related diagnoses this line of research is currently limited. The addition of self-reported sex identity data within VA electronic health records is one way to advance this line of research.

Participatory quantitative health impact assessment of urban and transport planning in cities: A review and research needs.

PubMed

Nieuwenhuijsen, Mark J; Khreis, Haneen; Verlinghieri, Ersilia; Mueller, Natalie; Rojas-Rueda, David

2017-06-01

Urban and transport planning have large impacts on public health, but these are generally not explicitly considered and/or quantified, partly because there are no comprehensive models, methods and tools readily available. Air pollution, noise, temperature, green space, motor vehicle crashes and physical activity are important pathways linking urban and transport planning and public health. For policy decision-making, it is important to understand and be able to quantify the full-chain from source through pathways to health effects and impacts to substantiate and effectively target actions. In this paper, we aim to provide an overview of recent studies on the health impacts related to urban and transport planning in cities, describe the need for novel participatory quantitative health impact assessments (HIA) and provide recommendations. To devise our searches and narrative, we were guided by a recent conceptual framework linking urban and transport planning, environmental exposures, behaviour and health. We searched PubMed, Web of Science, Science Direct, and references from relevant articles in English language from January 1, 1980, to November 1, 2016, using pre-defined search terms. The number of HIA studies is increasing rapidly, but there is lack of participatory integrated and full-chain HIA models, methods and tools. These should be based on the use of a systemic multidisciplinary/multisectorial approach and state-of-the-art methods to address questions such as what are the best, most feasible and needed urban and transport planning policy measures to improve public health in cities? Active citizen support and new forms of communication between experts and citizens and the involvement of all major stakeholders are crucial to find and successfully implement health promoting policy measures. We provided an overview of the current state-of-the art of HIA in cities and made recommendations for further work. The process on how to get there is as important and will provide answers to many crucial questions on e.g. how different disciplines can effectively work together, how to incorporate citizen and stakeholder opinion into quantitative HIA modelling for urban and transport planning, how different modelling and measurement methods can be effectively integrated, and whether a public health approach can bring about positive changes in urban and transport planning. Copyright © 2017. Published by Elsevier Ltd.

CEDRIC: a computerized chronic disease management system for urban, safety net clinics.

PubMed

Ogunyemi, Omolola; Mukherjee, Sukrit; Ani, Chizobam; Hindman, David; George, Sheba; Ilapakurthi, Ramarao; Verma, Mary; Dayrit, Melvin

2010-01-01

To meet the challenge of improving health care quality in urban, medically underserved areas of the US that have a predominance of chronic diseases such as diabetes, we have developed a new information system called CEDRIC for managing chronic diseases. CEDRIC was developed in collaboration with clinicians at an urban safety net clinic, using a community-participatory partnered research approach, with a view to addressing the particular needs of urban clinics with a high physician turnover and large uninsured/underinsured patient population. The pilot implementation focuses on diabetes management. In this paper, we describe the system's architecture and features.

Biometeorology for cities.

PubMed

Hondula, David M; Balling, Robert C; Andrade, Riley; Scott Krayenhoff, E; Middel, Ariane; Urban, Aleš; Georgescu, Matei; Sailor, David J

2017-09-01

Improvements in global sustainability, health, and equity will largely be determined by the extent to which cities are able to become more efficient, hospitable, and productive places. The development and evolution of urban areas has a significant impact on local and regional weather and climate, which subsequently affect people and other organisms that live in and near cities. Biometeorologists, researchers who study the impact of weather and climate on living creatures, are well positioned to help evaluate and anticipate the consequences of urbanization on the biosphere. Motivated by the 60th anniversary of the International Society of Biometeorology, we reviewed articles published in the Society's International Journal of Biometeorology over the period 1974-2017 to understand if and how biometeorologists have directed attention to urban areas. We found that interest in urban areas has rapidly accelerated; urban-oriented articles accounted for more than 20% of all articles published in the journal in the most recent decade. Urban-focused articles in the journal span five themes: measuring urban climate, theoretical foundations and models, human thermal comfort, human morbidity and mortality, and ecosystem impacts. Within these themes, articles published in the journal represent a sizeable share of the total academic literature. More explicit attention from urban biometeorologists publishing in the journal to low- and middle-income countries, indoor environments, animals, and the impacts of climate change on human health would help ensure that the distinctive perspectives of biometeorology reach the places, people, and processes that are the foci of global sustainability, health, and equity goals.

Defining migration and its health impact in China.

PubMed

Mou, J; Griffiths, S M; Fong, H F; Dawes, M G

2015-10-01

The scale and rapid expansion of urbanization resulting from socio-economic transformation in China at the beginning of the 21st century has accelerated rural-urban migration. Public health concerns from this increasing internal population mobility are now receiving attention from researchers. The health problems from internal migration pose particular demands on healthcare systems and relate to its demographic characteristics, with many younger and older people being left behind in the rural countryside. A review of literature, census, policy reports, government documents and media was undertaken to look at the classification system and health characteristics of China's internal migrants. It suggests that public health bears the consequences of political and economic decisions made elsewhere in society. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Consent Procedures and Participation Rates in School-Based Intervention and Prevention Research: Using a Multi-Component, Partnership-Based Approach to Recruit Participants

PubMed Central

Leff, Stephen S.; Franko, Debra L.; Weinstein, Elana; Beakley, Kelly; Power, Thomas J.

2009-01-01

Evaluations of school-based interventions and prevention programs typically require parental consent for students to participate. In school-based efforts, program evaluators may have limited access to parents and considerable effort is required to obtain signed consent. This issue is particularly salient when conducting research in under-resourced, urban schools, where parent involvement in the school setting may be somewhat limited. The aims of this article were to (a) examine the published school-based prevention and intervention literature to assess the state of the field in terms of consent procedures and participation rates; and (b) describe two examples of health promotion studies that used multi-component, partnership-based strategies in urban schools to encourage communication among children, their parents, and researchers. The purpose of the case studies was to generate hypotheses to advance the science related to school-based participant recruitment for research studies. Of nearly 500 studies reviewed, only 11.5% reported both consent procedures and participation rates. Studies using active consent procedures had a mean participation rate of 65.5% (range: 11–100%). This article highlights the need for researchers to report consent procedures and participation rates and describes partnership-based strategies used to enroll students into two urban, school-based health promotion studies. PMID:19834586

Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration.

PubMed

Soga, Masashi; Cox, Daniel T C; Yamaura, Yuichi; Gaston, Kevin J; Kurisu, Kiyo; Hanaki, Keisuke

2017-01-12

With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare.

Health Benefits of Urban Allotment Gardening: Improved Physical and Psychological Well-Being and Social Integration

PubMed Central

Soga, Masashi; Cox, Daniel T. C.; Yamaura, Yuichi; Gaston, Kevin J.; Kurisu, Kiyo; Hanaki, Keisuke

2017-01-01

With an ever-increasing urban population, promoting public health and well-being in towns and cities is a major challenge. Previous research has suggested that participating in allotment gardening delivers a wide range of health benefits. However, evidence from quantitative analyses is still scarce. Here, we quantify the effects, if any, of participating in allotment gardening on physical, psychological and social health. A questionnaire survey of 332 people was performed in Tokyo, Japan. We compared five self-reported health outcomes between allotment gardeners and non-gardener controls: perceived general health, subjective health complaints, body mass index (BMI), mental health and social cohesion. Accounting for socio-demographic and lifestyle variables, regression models revealed that allotment gardeners, compared to non-gardeners, reported better perceived general health, subjective health complaints, mental health and social cohesion. BMI did not differ between gardeners and non-gardeners. Neither frequency nor duration of gardening significantly influenced reported health outcomes. Our results highlight that regular gardening on allotment sites is associated with improved physical, psychological and social health. With the recent escalation in the prevalence of chronic diseases, and associated healthcare costs, this study has a major implication for policy, as it suggests that urban allotments have great potential for preventative healthcare. PMID:28085098

Overview of migration, poverty and health dynamics in Nairobi City's slum settlements.

PubMed

Zulu, Eliya M; Beguy, Donatien; Ezeh, Alex C; Bocquier, Philippe; Madise, Nyovani J; Cleland, John; Falkingham, Jane

2011-06-01

The Urbanization, Poverty, and Health Dynamics research program was designed to generate and provide the evidence base that would help governments, development partners, and other stakeholders understand how the urban slum context affects health outcomes in order to stimulate policy and action for uplifting the wellbeing of slum residents. The program was nested into the Nairobi Urban Health and Demographic Surveillance System, a uniquely rich longitudinal research platform, set up in Korogocho and Viwandani slum settlements in Nairobi city, Kenya. Findings provide rich insights on the context in which slum dwellers live and how poverty and migration status interacts with health issues over the life course. Contrary to popular opinions and beliefs that see slums as homogenous residential entities, the findings paint a picture of a highly dynamic and heterogeneous setting. While slum populations are highly mobile, about half of the population comprises relatively well doing long-term dwellers who have lived in slum settlements for over 10 years. The poor health outcomes that slum residents exhibit at all stages of the life course are rooted in three key characteristics of slum settlements: poor environmental conditions and infrastructure; limited access to services due to lack of income to pay for treatment and preventive services; and reliance on poor quality and mostly informal and unregulated health services that are not well suited to meeting the unique realities and health needs of slum dwellers. Consequently, policies and programs aimed at improving the wellbeing of slum dwellers should address comprehensively the underlying structural, economic, behavioral, and service-oriented barriers to good health and productive lives among slum residents.

Temperature, ozone, and mortality in urban and non-urban counties in the northeastern United States.

PubMed

Madrigano, Jaime; Jack, Darby; Anderson, G Brooke; Bell, Michelle L; Kinney, Patrick L

2015-01-07

Most health effects studies of ozone and temperature have been performed in urban areas, due to the available monitoring data. We used observed and interpolated data to examine temperature, ozone, and mortality in 91 urban and non-urban counties. Ozone measurements were extracted from the Environmental Protection Agency's Air Quality System. Meteorological data were supplied by the National Center for Atmospheric Research. Observed data were spatially interpolated to county centroids. Daily internal-cause mortality counts were obtained from the National Center for Health Statistics (1988-1999). A two-stage Bayesian hierarchical model was used to estimate each county's increase in mortality risk from temperature and ozone. We examined county-level associations according to population density and compared urban (≥1,000 persons/mile(2)) to non-urban (<1,000 persons/mile(2)) counties. Finally, we examined county-level characteristics that could explain variation in associations by county. A 10 ppb increase in ozone was associated with a 0.45% increase in mortality (95% PI: 0.08, 0.83) in urban counties, while this same increase in ozone was associated with a 0.73% increase (95% PI: 0.19, 1.26) in non-urban counties. An increase in temperature from 70°F to 90°F (21.2°C 32.2°C) was associated with a 8.88% increase in mortality (95% PI: 7.38, 10.41) in urban counties and a 8.08% increase (95% PI: 6.16, 10.05) in non-urban counties. County characteristics, such as population density, percentage of families living in poverty, and percentage of elderly residents, partially explained the variation in county-level associations. While most prior studies of ozone and temperature have been performed in urban areas, the impacts in non-urban areas are significant, and, for ozone, potentially greater. The health risks of increasing temperature and air pollution brought on by climate change are not limited to urban areas.

Access and utilisation of primary health care services comparing urban and rural areas of Riyadh Providence, Kingdom of Saudi Arabia.

PubMed

Alfaqeeh, Ghadah; Cook, Erica J; Randhawa, Gurch; Ali, Nasreen

2017-02-02

The Kingdom of Saudi Arabia (KSA) has seen an increase in chronic diseases. International evidence suggests that early intervention is the best approach to reduce the burden of chronic disease. However, the limited research available suggests that health care access remains unequal, with rural populations having the poorest access to and utilisation of primary health care centres and, consequently, the poorest health outcomes. This study aimed to examine the factors influencing the access to and utilisation of primary health care centres in urban and rural areas of Riyadh province of the KSA. A questionnaire survey was carried out to identify the barriers and enablers to accessing PHCS in rural (n = 5) and urban (n = 5) areas of Riyadh province, selected on the classification of the population density of the governorates. An adapted version of the NHS National Survey Programme was administered that included 50 questions over 11 sections that assessed a wide range of factors related to respondent's access and experience of the PHCS. A total of 935 responses were obtained with 52.9% (n = 495) from urban areas and the remaining 47.1% (n = 440) from rural areas of Riyadh province. This study highlights that there are high levels of satisfaction among patients among all PHCS. In relation to differences between urban and rural respondents, the findings indicated that there were significant variations in relation to: education level, monthly income, medical investigations, receiving blood tests on time, extra opening hours, distance, cleanliness and health prevention. Core barriers for rural patients related to the distance to reach PHCS, cleanliness of the PHCS, receiving health prevention and promotion services, which should serve to improve health outcomes. This study highlighted important differences in access to and utilisation of PHCS between urban and rural populations in Riyadh province in the KSA. These findings have implications for policy and planning of PHCCs and reducing inequalities in health care between rural and urban populations and contributing to a reduction in the chronic disease burden in Riyadh province.

All Rural Places Are Not Created Equal: Revisiting the Rural Mortality Penalty in the United States

PubMed Central

2014-01-01

Objectives. I investigated mortality disparities between urban and rural areas by measuring disparities in urban US areas compared with 6 rural classifications, ranging from suburban to remote locales. Methods. Data from the Compressed Mortality File, National Center for Health Statistics, from 1968 to 2007, was used to calculate age-adjusted mortality rates for all rural and urban regions by year. Criteria measuring disparity between regions included excess deaths, annual rate of change in mortality, and proportion of excess deaths by population size. I used multivariable analysis to test for differences in determinants across regions. Results. The rural mortality penalty existed in all rural classifications, but the degree of disparity varied considerably. Rural–urban continuum code 6 was highly disadvantaged, and rural–urban continuum code 9 displayed a favorable mortality profile. Population, socioeconomic, and health care determinants of mortality varied across regions. Conclusions. A 2-decade long trend in mortality disparities existed in all rural classifications, but the penalty was not distributed evenly. This constitutes an important public health problem. Research should target the slow rates of improvement in mortality in the rural United States as an area of concern. PMID:25211763

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,…

Urban groundwater quality in sub-Saharan Africa: current status and implications for water security and public health

NASA Astrophysics Data System (ADS)

Lapworth, D. J.; Nkhuwa, D. C. W.; Okotto-Okotto, J.; Pedley, S.; Stuart, M. E.; Tijani, M. N.; Wright, J.

2017-06-01

Groundwater resources are important sources of drinking water in Africa, and they are hugely important in sustaining urban livelihoods and supporting a diverse range of commercial and agricultural activities. Groundwater has an important role in improving health in sub-Saharan Africa (SSA). An estimated 250 million people (40% of the total) live in urban centres across SSA. SSA has experienced a rapid expansion in urban populations since the 1950s, with increased population densities as well as expanding geographical coverage. Estimates suggest that the urban population in SSA will double between 2000 and 2030. The quality status of shallow urban groundwater resources is often very poor due to inadequate waste management and source protection, and poses a significant health risk to users, while deeper borehole sources often provide an important source of good quality drinking water. Given the growth in future demand from this finite resource, as well as potential changes in future climate in this region, a detailed understanding of both water quantity and quality is required to use this resource sustainably. This paper provides a comprehensive assessment of the water quality status, both microbial and chemical, of urban groundwater in SSA across a range of hydrogeological terrains and different groundwater point types. Lower storage basement terrains, which underlie a significant proportion of urban centres in SSA, are particularly vulnerable to contamination. The relationship between mean nitrate concentration and intrinsic aquifer pollution risk is assessed for urban centres across SSA. Current knowledge gaps are identified and future research needs highlighted.

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

Making the narrative walk-in-real-time methodology relevant for public health intervention: towards an integrative approach.

PubMed

Miaux, Sylvie; Drouin, Louis; Morency, Patrick; Paquin, Sophie; Gauvin, Lise; Jacquemin, Christophe

2010-11-01

The purpose of this article is to describe a novel approach for understanding the subjective experience of being a pedestrian in urban settings. In so doing, we take into account the "experience of the body in movement" as described in different theories and according to different methods, and develop a tool to allow citizens and urban planners to exchange ideas about how to make cities more walkable. Finally, we present the adaptation of the approach for use in public health and provide a rationale for its more widespread use in place and health research. Copyright © 2010 Elsevier Ltd. All rights reserved.

The relationship between urban forests and race: A meta-analysis

PubMed Central

Watkins, Shannon Lea; Gerrish, Ed

2018-01-01

There is ample evidence that urban trees benefit the physical, mental, and social health of urban residents. The environmental justice hypothesis posits that environmental amenities are inequitably low in poor and minority communities, and predicts these communities experience fewer urban environmental benefits. Some previous research has found that urban forest cover is inequitably distributed by race, though other studies have found no relationship or negative inequity. These conflicting results and the single-city nature of the current literature suggest a need for a research synthesis. Using a systematic literature search and meta-analytic techniques, we examined the relationship between urban forest cover and race. First, we estimated the average (unconditional) relationship between urban forest cover and race across studies (studies = 40; effect sizes = 388). We find evidence of significant race-based inequity in urban forest cover. Second, we included characteristics of the original studies and study sites in meta-regressions to illuminate drivers of variation of urban forest cover between studies. Our meta-regressions reveal that the relationship varies across racial groups and by study methodology. Models reveal significant inequity on public land and that environmental and social characteristics of cities help explain variation across studies. As tree planting and other urban forestry programs proliferate, urban forestry professionals are encouraged to consider the equity consequences of urban forestry activities, particularly on public land. PMID:29289843

The relationship between urban forests and race: A meta-analysis.

PubMed

Watkins, Shannon Lea; Gerrish, Ed

2018-03-01

There is ample evidence that urban trees benefit the physical, mental, and social health of urban residents. The environmental justice hypothesis posits that environmental amenities are inequitably low in poor and minority communities, and predicts these communities experience fewer urban environmental benefits. Some previous research has found that urban forest cover is inequitably distributed by race, though other studies have found no relationship or negative inequity. These conflicting results and the single-city nature of the current literature suggest a need for a research synthesis. Using a systematic literature search and meta-analytic techniques, we examined the relationship between urban forest cover and race. First, we estimated the average (unconditional) relationship between urban forest cover and race across studies (studies = 40; effect sizes = 388). We find evidence of significant race-based inequity in urban forest cover. Second, we included characteristics of the original studies and study sites in meta-regressions to illuminate drivers of variation of urban forest cover between studies. Our meta-regressions reveal that the relationship varies across racial groups and by study methodology. Models reveal significant inequity on public land and that environmental and social characteristics of cities help explain variation across studies. As tree planting and other urban forestry programs proliferate, urban forestry professionals are encouraged to consider the equity consequences of urban forestry activities, particularly on public land. Copyright © 2017. Published by Elsevier Ltd.

Measuring high-density built environment for public health research: Uncertainty with respect to data, indicator design and spatial scale.

PubMed

Sun, Guibo; Webster, Chris; Ni, Michael Y; Zhang, Xiaohu

2018-05-07

Uncertainty with respect to built environment (BE) data collection, measure conceptualization and spatial scales is evident in urban health research, but most findings are from relatively lowdensity contexts. We selected Hong Kong, an iconic high-density city, as the study area as limited research has been conducted on uncertainty in such areas. We used geocoded home addresses (n=5732) from a large population-based cohort in Hong Kong to extract BE measures for the participants' place of residence based on an internationally recognized BE framework. Variability of the measures was mapped and Spearman's rank correlation calculated to assess how well the relationships among indicators are preserved across variables and spatial scales. We found extreme variations and uncertainties for the 180 measures collected using comprehensive data and advanced geographic information systems modelling techniques. We highlight the implications of methodological selection and spatial scales of the measures. The results suggest that more robust information regarding urban health research in high-density city would emerge if greater consideration were given to BE data, design methods and spatial scales of the BE measures.

Mechanisms Involved in the Mitigation of Urban Heat Islands through Vegetation

NASA Astrophysics Data System (ADS)

Montalto, F. A.; Smalls-Mantey, L.

2016-12-01

Urban heat islands are one of many challenges presented by today's unprecedented patterns of urbanization. At higher densities, urban populations are more vulnerable to the increased temperatures that accompany urban landscape change. Though in the US it is funded principally as a means of stormwater management, urban green infrastructure (GI) actually alters hydrologic, energetic, and thermal budgets of urban environments, with a suite of potential co-benefits related to the health of people and ecosystems. Recent research has underscored the roles that vegetation plays in such processes, for example by facilitating evapotranspiration, and regulating air temperature and water availability. While the magnitude of these and other impacts is determined in part by the size, type, location, and configuration of GI facilities, few studies have attempted to characterize and to quantify how various vegetation-mediated processes in GI systems impact the energy and thermal properties of their surroundings. Using data collected at rooftop and ground level GI facilities including green roofs and bioretention areas monitored by Drexel University, this research illustrates the role that processes such as evapotranspiration play in the individual GI site cooling potential, reducing neighborhood vulnerability to the urban heat island effect.

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

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya

PubMed Central

J. Madise, Nyovani; Ziraba, Abdhalah K.; Inungu, Joseph; Khamadi, Samoel A.; Ezeh, Alex; Zulu, Eliya M.; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-01-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. PMID:22591621

Urban-rural contrasts in fitness, physical activity, and sedentary behaviour in adolescents.

PubMed

Machado-Rodrigues, Aristides M; Coelho-E-Silva, Manuel J; Mota, Jorge; Padez, Cristina; Martins, Raul A; Cumming, Sean P; Riddoch, Chris; Malina, Robert M

2014-03-01

Research considering physical activity (PA), physical inactivity and health outcomes among urban and rural youth has produced equivocal findings. This study examined PA, physical inactivity, sedentary behaviours and cardiorespiratory fitness (CRF) in adolescents from urban and rural communities in the Portuguese Midlands. The sample included 362 adolescents (165 males, 197 females) of 13-16 years of age. CRF was assessed by the PACER test. A GT1M accelerometer was used to record 5 consecutive days of PA and time spent sedentary. Analyses of covariance (chronological age as co-variate) were performed to test the effect of the area of residence on sedentary behaviour, PA and CRF. Urban youth of both sexes spent less time in sedentary activities than rural youth. Urban males were more active than rural peers at the weekend, whereas urban females were significantly less active than rural females on week days and across all days assessed. Rural youth of both sexes had higher levels of CRF than urban youth. Area of residence was related to aerobic fitness, PA and time spent in sedentary behaviours among Portuguese youth. Interventions seeking to enhance health and active lifestyles in Portuguese youth should consider the potential impact of socio-geographic factors.

Traditional medicine for the rich and knowledgeable: challenging assumptions about treatment-seeking behaviour in rural and peri-urban Nepal

PubMed Central

Thorsen, Rikke Stamp; Pouliot, Mariève

2016-01-01

Traditional medicine is commonly assumed to be a crucial health care option for poor households in developing countries. However, little research has been done in Asia to quantify the reliance on traditional medicine and its determinants. This research contributes to filling in this knowledge gap using household survey data collected from 571 households in three rural and peri-urban sites in Nepal in 2012. Questions encompassed household socioeconomic characteristics, illness characteristics, and treatment-seeking behaviour. Treatment choice was investigated through bivariate analyses. Results show that traditional medicine, and especially self-treatment with medicinal plants, prevail as treatment options in both rural and peri-urban populations. Contrarily to what is commonly assumed, high income is an important determinant of use of traditional medicine. Likewise, knowledge of medicinal plants, age, education, gender and illness chronicity were also significant determinants. The importance of self-treatment with medicinal plants should inform the development of health policy tailored to people’s treatment-seeking behaviour. PMID:26130610

Morbidity Forecast in Cities: A Study of Urban Air Pollution and Respiratory Diseases in the Metropolitan Region of Curitiba, Brazil.

PubMed

de Souza, Fabio Teodoro

2018-05-29

In the last two decades, urbanization has intensified, and in Brazil, about 90% of the population now lives in urban centers. Atmospheric patterns have changed owing to the high growth rate of cities, with negative consequences for public health. This research aims to elucidate the spatial patterns of air pollution and respiratory diseases. A data-based model to aid local urban management to improve public health policies concerning air pollution is described. An example of data preparation and multivariate analysis with inventories from different cities in the Metropolitan Region of Curitiba was studied. A predictive model with outstanding accuracy in prediction of outbreaks was developed. Preliminary results describe relevant relations among morbidity scales, air pollution levels, and atmospheric seasonal patterns. The knowledge gathered here contributes to the debate on social issues and public policies. Moreover, the results of this smaller scale study can be extended to megacities.

Indo-Fijian Children's BMI : In the Context of Urbanization, Embodied Capital, and Food Choice Trade-offs.

PubMed

Neill, Dawn B

2007-09-01

Health research has shown that overweight and obesity in children and adults are becoming significant public health problems in the developing world. Evidence suggests that this phenomenon is more marked in urban than rural areas and may be associated with modernization. However, the underlying reasons for this nutrition transition remain unclear. Dietary shifts, often in conjunction with income and time constraints in urban environments, may entail a greater reliance on more convenient sugar and fat-dense food. Also, the necessity of labor-intensive agricultural work to meet rural subsistence needs is supplanted in urban environments by sedentary work. This paper extends the application of human behavioral ecology theory into the realm of international development and policy by applying Kaplan's embodied capital theory to explore differences in food habits and nutritional status of Indo-Fijian children within the context of urbanization. Urban high-embodied-capital women demonstrate higher rates of wage-earning employment than urban low-embodied-capital or rural women. Findings indicate that urban high-embodied-capital households spend significantly more on food purchases, purchase a greater proportion of processed foods, and have children with higher body mass indexes (BMI) than do urban low-embodied-capital or rural households. This suggests that urban high-embodied-capital mothers, who tend to be employed, may be making trade-offs between income and food choices.

"There's a housing crisis going on in Sydney for Aboriginal people": focus group accounts of housing and perceived associations with health.

PubMed

Andersen, Melanie J; Williamson, Anna B; Fernando, Peter; Redman, Sally; Vincent, Frank

2016-05-24

Poor housing is widely cited as an important determinant of the poor health status of Aboriginal Australians, as for indigenous peoples in other wealthy nations with histories of colonisation such as Canada, the United States of America and New Zealand. While the majority of Aboriginal Australians live in urban areas, most research into housing and its relationship with health has been conducted with those living in remote communities. This study explores the views of Aboriginal people living in Western Sydney about their housing circumstances and what relationships, if any, they perceive between housing and health. Four focus groups were conducted with clients and staff of an Aboriginal community-controlled health service in Western Sydney (n = 38). Inductive, thematic analysis was conducted using framework data management methods in NVivo10. Five high-level themes were derived: the battle to access housing; secondary homelessness; overcrowding; poor dwelling conditions; and housing as a key determinant of health. Participants associated their challenging housing experiences with poor physical health and poor social and emotional wellbeing. Housing issues were said to affect people differently across the life course; participants expressed particular concern that poor housing was harming the health and developmental trajectories of many urban Aboriginal children. Housing was perceived as a pivotal determinant of health and wellbeing that either facilitates or hinders prospects for full and healthy lives. Many of the specific health concerns participants attributed to poor housing echo existing epidemiological research findings. These findings suggest that housing may be a key intervention point for improving the health of urban Aboriginal Australians.

Urbanization, economic development and health: evidence from China's labor-force dynamic survey.

PubMed

Chen, Hongsheng; Liu, Ye; Li, Zhigang; Xue, Desheng

2017-11-29

The frequent outbreak of environmental threats in China has resulted in increased criticism regarding the health effects of China's urbanization. Urbanization is a double-edged sword with regard to health in China. Although great efforts have been made to investigate the mechanisms through which urbanization influences health, the effect of both economic development and urbanization on health in China is still unclear, and how urbanization-health (or development-health) relationships vary among different income groups remain poorly understood. To bridge these gaps, the present study investigates the impact of both urbanization and economic development on individuals' self-rated health and its underlying mechanisms in China. We use data from the national scale of the 2014 China Labor-force Dynamics Survey to analyze the impact of China's urbanization and economic development on health. A total of 14,791 individuals were sampled from 401 neighborhoods within 124 prefecture-level cities. Multilevel ordered logistic models were applied. Model results showed an inverted U-shaped relationship between individuals' self-rated health and urbanization rates (with a turning point of urbanization rate at 42.0%) and a positive linear relationship between their self-rated health and economic development. Model results also suggested that the urbanization-health relationship was inverted U-shaped for high- and middle-income people (with a turning point of urbanization rate at 0.0% and 49.2%, respectively), and the development-health relationship was inverted U-shaped for high- and low-income people (with turning points of GDP per capita at 93,462 yuan and 71,333 yuan, respectively) and linear for middle-income people. The impact of urbanization and economic development on health in China is complicated. Careful assessments are needed to understand the health impact of China's rapid urbanization. Social and environmental problems arising from rapid urbanization and economic growth should be addressed. Equitable provision of health services are needed to improve low-income groups' health in highly urbanized cities.

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.

Examining the Effect of Household Wealth and Migration Status on Safe Delivery Care in Urban India, 1992–2006

PubMed Central

Singh, Prashant Kumar; Rai, Rajesh Kumar; Singh, Lucky

2012-01-01

Background Although the urban health issue has been of long-standing interest to public health researchers, majority of the studies have looked upon the urban poor and migrants as distinct subgroups. Another concern is, whether being poor and at the same time migrant leads to a double disadvantage in the utilization of maternal health services? This study aims to examine the trends and factors that affect safe delivery care utilization among the migrants and the poor in urban India. Methodology/Principal Findings Using data from the National Family Health Survey, 1992–93 and 2005–06, this study grouped the household wealth and migration status into four distinct categories poor-migrant, poor-non migrant, non poor-migrant, non poor-non migrant. Both chi-square test and binary logistic regression were performed to examine the influence of household wealth and migration status on safe delivery care utilization among women who had experienced a birth in the four years preceding the survey. Results suggest a decline in safe delivery care among poor-migrant women during 1992–2006. The present study identifies two distinct groups in terms of safe delivery care utilization in urban India – one for poor-migrant and one for non poor-non migrants. While poor-migrant women were most vulnerable, non poor-non migrant women were the highest users of safe delivery care. Conclusion This study reiterates the inequality that underlies the utilization of maternal healthcare services not only by the urban poor but also by poor-migrant women, who deserve special attention. The ongoing programmatic efforts under the National Urban Health Mission should start focusing on the poorest of the poor groups such as poor-migrant women. Importantly, there should be continuous evaluation to examine the progress among target groups within urban areas. PMID:22970324

Urbanicity-Related Variation in Help-Seeking and Services Utilization among Preschool-Age Children with Autism in Taiwan

ERIC Educational Resources Information Center

Chen, Chuan-Yu; Liu, Chieh-Yu; Su, Wen-Chuan; Huang, Su-Ling; Lin, Keh-Ming

2008-01-01

The present study examines urbanicity-related differences in help-seeking process among preschool children with autism and investigates the factors associated with utilization of autism-related services within the year of diagnosis. Using the 1997-2004 National Health Insurance Research Database (NHIRD) in Taiwan, we identified a total of 3495…

Childhood Trauma in Today's Urban Classroom: Moving beyond the Therapist's Office

ERIC Educational Resources Information Center

R. B.-Banks, Yvonne; Meyer, Joseph

2017-01-01

Childhood trauma leaves its marks on the brain (Sandi, 2013) with unseen scars as evident in brain research. Addressing childhood trauma in today's urban classrooms is no small feat. According to the 2011-12 National Survey of Children's Health, nearly 35 million children in the United States are living with emotional and psychological trauma.…

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.

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.

QUALITY ASSURANCE AND SITE MANAGEMENT FOR PRIMENET AND URBAN ULTRAVIOLET RADIATION RESEARCH MONITORING PROGRAM.

EPA Science Inventory

Because exposure to ultraviolet (UV) radiation is an ecosystem stressor and poses a human health risk, the National Exposure Research Laboratory (NERL) has undertaken a research program to measure the intensity of UV-B radiation at various locations throughout the U.S. In Septem...

Relationship between urban sprawl and physical activity, obesity, and morbidity.

PubMed

Ewing, Reid; Schmid, Tom; Killingsworth, Richard; Zlot, Amy; Raudenbush, Stephen

2003-01-01

To determine the relationship between urban sprawl, health, and health-related behaviors. Cross-sectional analysis using hierarchical modeling to relate characteristics of individuals and places to levels of physical activity, obesity, body mass index (BMI), hypertension, diabetes, and coronary heart disease. U.S. counties (448) and metropolitan areas (83). Adults (n = 206,992) from pooled 1998, 1999, and 2000 Behavioral Risk Factor Surveillance System (BRFSS). Sprawl indices, derived with principal components analysis from census and other data, served as independent variables. Self-reported behavior and health status from BRFSS served as dependent variables. After controlling for demographic and behavioral covariates, the county sprawl index had small but significant associations with minutes walked (p = .004), obesity (p < .001), BMI (p = .005), and hypertension (p = .018). Residents of sprawling counties were likely to walk less during leisure time, weigh more, and have greater prevalence of hypertension than residents of compact counties. At the metropolitan level, sprawl was similarly associated with minutes walked (p = .04) but not with the other variables. This ecologic study reveals that urban form could be significantly associated with some forms of physical activity and some health outcomes. More research is needed to refine measures of urban form, improve measures of physical activity, and control for other individual and environmental influences on physical activity, obesity, and related health 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

Determinants of self-rated health in elderly populations in urban areas in Slovenia, Lithuania and UK: findings of the EURO-URHIS 2 survey.

PubMed

Stanojevic Jerkovic, Olivera; Sauliune, Skirmante; Šumskas, Linas; Birt, Christopher A; Kersnik, Janko

2017-05-01

Ageing imposes extra financial burdens on social and health services in developed countries. Self-rated health (SRH) is considered to be both a reliable measurement of overall health status including morbidity and mortality and an important predictor of hospitalization, functional impairment and greater demand for health-care services in the elderly. Our aim was to identify factors associated with poor SRH in elderly populations and investigate possible differences between urban areas in Slovenia, Lithuania and UK. Data were obtained from population-based surveys from the European Urban Health Indicator System Part 2 project. The stratified representative sample (41% men and 59% women) consisted of a total of 2547 respondents aged ≥65 from the urban areas in the three countries. The prevalence of poor SRH was highest in Lithuanian urban areas. The strongest factors associated with poor SRH were low education [OR (odds ratio) 4.3, 95% CI (confidence interval) 2.5-7.3, P < 0.001], restriction of activities attributable to a chronic disease (OR 2.6, 95% CI 2.2-3.0, P < 0.001), inadequate physical activity (OR 1.7, 95% CI 1.2-2.5, P = 0.007) and poor mental health (OR 1.1, 95% CI 1.1-1.2, P < 0.001). The main factors associated with poor SRH by country included the following: living alone (Slovenia) (OR 2.0, 95% CI 1.1-3.7, P = 0,023), female sex (Lithuania) (OR 2.0, 95% CI 1.0-4.2, P = 0.058) and inadequate physical activity (UK) (OR 2.2, 95% CI 1.3-3.6, P = 0,003). Despite different levels of poor SRH, the factors associated with poor SRH were similar for the urban areas of the three countries. Factors associated with poor SRH in the urban areas could also reflect either cultural differences or specific situations for elderly in that country, which need further research. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Emerging contaminants of public health significance as water quality indicator compounds in the urban water cycle.

PubMed

Pal, Amrita; He, Yiliang; Jekel, Martin; Reinhard, Martin; Gin, Karina Yew-Hoong

2014-10-01

The contamination of the urban water cycle (UWC) with a wide array of emerging organic compounds (EOCs) increases with urbanization and population density. To produce drinking water from the UWC requires close examination of their sources, occurrence, pathways, and health effects and the efficacy of wastewater treatment and natural attenuation processes that may occur in surface water bodies and groundwater. This paper researches in details the structure of the UWC and investigates the routes by which the water cycle is increasingly contaminated with compounds generated from various anthropogenic activities. Along with a thorough survey of chemicals representing compound classes such as hormones, antibiotics, surfactants, endocrine disruptors, human and veterinary pharmaceuticals, X-ray contrast media, pesticides and metabolites, disinfection-by-products, algal toxins and taste-and-odor compounds, this paper provides a comprehensive and holistic review of the occurrence, fate, transport and potential health impact of the emerging organic contaminants of the UWC. This study also illustrates the widespread distribution of the emerging organic contaminants in the different aortas of the ecosystem and focuses on future research needs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Ecohealth approach to urban waste management: exposure to environmental pollutants and health risks in Yamoussoukro, Côte d'Ivoire.

PubMed

Kouamé, Parfait K; Dongo, Kouassi; Nguyen-Viet, Hung; Zurbrügg, Christian; Lüthi, Christoph; Hattendorf, Jan; Utzinger, Jürg; Biémi, Jean; Bonfoh, Bassirou

2014-10-02

Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d'Ivoire. We undertook trans-disciplinary research within an Ecohealth approach, comprised of a participatory workshop with stakeholders and mapping of exposure patterns. A total of 492 randomly selected households participated in a cross-sectional survey. Waste deposit sites were characterised and 108 wastewater samples were subjected to laboratory examinations. The physico-chemical parameters of the surface water (temperature, pH, conductivity, potential oxidise reduction, BOD5, COD, dissolved oxygen, nitrates, ammonia and total Kendal nitrogen) did not comply with World Health Organization standards of surface water quality. Questionnaire results showed that malaria was the most commonly reported disease. Diarrhoea and malaria were associated with poor sanitation. Households having dry latrines had a higher risk of diarrhoea (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.2-2.7) compared to latrines with septic tanks and also a higher risk for malaria (OR = 1.9, 95% (CI) 1.1-3.3). Our research showed that combining health and environmental assessments enables a deeper understanding of environmental threats and disease burdens linked to poor waste management. Further study should investigate the sanitation strategy aspects that could reduce the environmental and health risks in the study area.

Ecohealth Approach to Urban Waste Management: Exposure to Environmental Pollutants and Health Risks in Yamoussoukro, Côte d’Ivoire

PubMed Central

Kouamé, Parfait K.; Dongo, Kouassi; Nguyen-Viet, Hung; Zurbrügg, Christian; Lüthi, Christoph; Hattendorf, Jan; Utzinger, Jürg; Biémi, Jean; Bonfoh, Bassirou

2014-01-01

Poor waste management is a key driver of ill-health in urban settlements of developing countries. The current study aimed at assessing environmental and human health risks related to urban waste management in Yamoussoukro, the political capital of Côte d’Ivoire. We undertook trans-disciplinary research within an Ecohealth approach, comprised of a participatory workshop with stakeholders and mapping of exposure patterns. A total of 492 randomly selected households participated in a cross-sectional survey. Waste deposit sites were characterised and 108 wastewater samples were subjected to laboratory examinations. The physico-chemical parameters of the surface water (temperature, pH, conductivity, potential oxidise reduction, BOD5, COD, dissolved oxygen, nitrates, ammonia and total Kendal nitrogen) did not comply with World Health Organization standards of surface water quality. Questionnaire results showed that malaria was the most commonly reported disease. Diarrhoea and malaria were associated with poor sanitation. Households having dry latrines had a higher risk of diarrhoea (odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.2–2.7) compared to latrines with septic tanks and also a higher risk for malaria (OR = 1.9, 95% (CI) 1.1–3.3). Our research showed that combining health and environmental assessments enables a deeper understanding of environmental threats and disease burdens linked to poor waste management. Further study should investigate the sanitation strategy aspects that could reduce the environmental and health risks in the study area. PMID:25279545

Infectious Diseases, Urbanization and Climate Change: Challenges in Future China

PubMed Central

Tong, Michael Xiaoliang; Hansen, Alana; Hanson-Easey, Scott; Cameron, Scott; Xiang, Jianjun; Liu, Qiyong; Sun, Yehuan; Weinstein, Philip; Han, Gil-Soo; Williams, Craig; Bi, Peng

2015-01-01

China is one of the largest countries in the world with nearly 20% of the world’s population. There have been significant improvements in economy, education and technology over the last three decades. Due to substantial investments from all levels of government, the public health system in China has been improved since the 2003 severe acute respiratory syndrome (SARS) outbreak. However, infectious diseases still remain a major population health issue and this may be exacerbated by rapid urbanization and unprecedented impacts of climate change. This commentary aims to explore China’s current capacity to manage infectious diseases which impair population health. It discusses the existing disease surveillance system and underscores the critical importance of strengthening the system. It also explores how the growing migrant population, dramatic changes in the natural landscape following rapid urbanization, and changing climatic conditions can contribute to the emergence and re-emergence of infectious disease. Continuing research on infectious diseases, urbanization and climate change may inform the country’s capacity to deal with emerging and re-emerging infectious diseases in the future. PMID:26371017

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.

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.

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.

Aboriginal Australians' experience of social capital and its relevance to health and wellbeing in urban settings.

PubMed

Browne-Yung, Kathryn; Ziersch, Anna; Baum, Fran; Gallaher, Gilbert

2013-11-01

Social capital has been linked to physical and mental health. While definitions of social capital vary, all include networks of social relationships and refer to the subsequent benefits and disadvantages accrued to members. Research on social capital for Aboriginal Australians has mainly focused on discrete rural and remote Aboriginal contexts with less known about the features and health and other benefits of social capital in urban settings. This paper presents findings from in-depth interviews with 153 Aboriginal people living in urban areas on their experiences of social capital. Of particular interest was how engagement in bonding and bridging networks influenced health and wellbeing. Employing Bourdieu's relational theory of capital where resources are unequally distributed and reproduced in society we found that patterns of social capital are strongly associated with economic, social and cultural position which in turn reflects the historical experiences of dispossession and disadvantage experienced by Aboriginal Australians. Social capital was also found to both reinforce and influence Aboriginal cultural identity, and had both positive and negative impacts on health and wellbeing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Urban Climate, Ozone Formation, and Public Health: Should Heat be Regulated as a Traditional Air Pollutant?

NASA Astrophysics Data System (ADS)

Stone, B.

2003-12-01

The return of record breaking heat waves to North American and European cities in 2003 highlights the growing need for urban planners to develop heat mitigation strategies for large metropolitan regions. Long associated with public health through its effects on human heat stress and heat related mortality, rising urban temperatures also hold important implications for regional air quality. This presentation will outline the results of a study focused on the relationship between regional temperatures and annual tropospheric ozone exceedances in the fifty largest (by population) metropolitan regions in the United States. With the aid of data from the EPA's National Emissions Inventory and NASA's Earth Observing System Data and Information System, this study examines trends in metropolitan emissions of nitrogen oxides, volatile organic compounds, mean regional temperatures, and annual ozone exceedances in U.S. metropolitan regions for the years 1990 through 1999. The intent of this work is to better establish connections between recent trends urban climate and ozone formation and to explore policy approaches to mitigating urban temperatures through physical planning. The results of this research indicate that annual violations of the national ozone standard during the decade of the 1990s were more closely associated with regional temperatures than with the emissions of regulated ozone precursors from mobile and stationary sources. Based on the results of this analysis, I argue that the air quality management strategies outlined in the Clean Air Act may be proving insufficient to control ozone formation due to ongoing and unanticipated changes in global and regional climate. I further argue that the emergence of urban heat as a significant threat to human health demands a strategic response from the fields of urban planning and public health. The presentation will conclude with a discussion of the linkages between urban form and ambient heat and will outline a set of policy approaches that have proven successful in mitigating urban heat production.

Health co-benefits and risks of public health adaptation strategies to climate change: a review of current literature.

PubMed

Cheng, June J; Berry, Peter

2013-04-01

Many public health adaptation strategies have been identified in response to climate change. This report reviews current literature on health co-benefits and risks of these strategies to gain a better understanding of how they may affect health. A literature review was conducted electronically using English language literature from January 2000 to March 2012. Of 812 articles identified, 22 peer-reviewed articles that directly addressed health co-benefits or risks of adaptation were included in the review. The co-benefits and risks identified in the literature most commonly relate to improvements in health associated with adaptation actions that affect social capital and urban design. Health co-benefits of improvements in social capital have positive influences on mental health, independently of other determinants. Risks included reinforcing existing misconceptions regarding health. Health co-benefits of urban design strategies included reduced obesity, cardiovascular disease and improved mental health through increased physical activity, cooling spaces (e.g., shaded areas), and social connectivity. Risks included pollen allergies with increased urban green space, and adverse health effects from heat events through the use of air conditioning. Due to the current limited understanding of the full impacts of the wide range of existing climate change adaptation strategies, further research should focus on both unintended positive and negative consequences of public health adaptation.

[Urban ecosystem services: A review].

PubMed

Mao, Qi-zheng; Huang, Gan-lin; Wu, Jian-guo

2015-04-01

Maintaining and improving ecosystem services in urban areas and human well-being are essential for sustainable development and therefore constitute an important topic in urban ecology. Here we reviewed studies on ecosystem services in urban areas. Based on the concept and classification of urban ecosystem services, we summarized characteristics of urban ecosystem services, including the human domination, high demand of ecosystem services in urban areas, spatial heterogeneity and temporal dynamics of ecosystem services supply and demand in urban areas, multi-services of urban green infrastructures, the socio-economic dimension of ecosystem services supply and ecosystem disservices in urban areas. Among different urban ecosystem services, the regulating service and cultural service are particularly indispensable to benefit human health. We pointed out that tradeoffs among different types of ecosystem services mostly occur between supportive service and cultural service, as well as regulating service and cultural service. In particular, we emphasized the relationship between landscape design (i.e. green infrastructure) and ecosystem services supply. Finally, we discussed current gaps to link urban ecosystem services studies to landscape design and management and pointed out several directions for future research in urban ecosystem services.

The Effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City.

PubMed

Melis, Giulia; Gelormino, Elena; Marra, Giulia; Ferracin, Elisa; Costa, Giuseppe

2015-11-20

Mental health (MH) has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression) are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy) urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces) and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment) and contextual social environment (SE) variables (social and physical disorder, crime rates). Data was extracted from the Turin Longitudinal Study (TLS)-a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE) indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life.

Urbanization, socioeconomic status and health disparity in China.

PubMed

Miao, Jia; Wu, Xiaogang

2016-11-01

While urbanization is associated with a wide range of human welfare outcomes, its impacts on population health are much less obvious. This article aims to investigate how rapid urbanization in contemporary China affects health, and how it shapes health disparities between groups of different socioeconomic status (SES). Using data from eight waves of the China Health and Nutrition Survey (CHNS) spanning a period of 20 years from 1991 to 2011, we examine the confounding effects of urbanization on health and the income-health relationship and explore the underlying mechanism. Results from multilevel analysis show that living in more urbanized areas increases the risk of acquiring chronic diseases, and the health penalty of urbanization is more severe among those with a higher income. Lifestyle is the pathway through which urbanization affects health, and a high-fat diet and decreased physical activity diminish the health benefit brought by high income and accelerate health decline in more urbanized areas. These results suggest an urgent need to design and implement health promotion programs to encourage healthy lifestyles in China under rapid urbanization. Copyright © 2016 Elsevier Ltd. All rights reserved.

Characterizing urban areas with good sound quality: development of a research protocol.

PubMed

van Kempen, Elise; Devilee, Jeroen; Swart, Wim; van Kamp, Irene

2014-01-01

Due to rapid urbanization, the spatial variation between wanted and unwanted sounds will decrease or even disappear. Consequently, the characteristics of (urban) areas where people can temporarily withdraw themselves from urban stressors such as noise may change or become increasingly scarce. Hardly any research has been carried out into the positive health effects of spending time in areas with a good sound quality. One of the problems is that an overview of what aspects determines good sound quality in urban areas and how these are interrelated is lacking. This paper reviews the literature pertaining to the sound quality of urban areas. Aim is to summarize what is known about the influence of social, spatial, and physical aspects other than sounds, on peoples' perception of urban sound qualities. Literature from both conventional sound research and from the so-called soundscape field, published between 2000 and the beginning of 2013 in English or Dutch, was evaluated. Although a general set of validated indicators that can be directly applied, is not available yet, a set of indicators was derived from the literature. These form the basis of a study protocol that will be applied in "Towards a Sustainable acoustic Environment", a project that aims to describe sound qualities at a low-scale level. Key-elements of this study protocol, including a questionnaire and the systematic audit of neighborhoods, were presented in this paper.

Pet Dogs Benefit Owners' Health: A "Natural Experiment" in China

ERIC Educational Resources Information Center

Headey, Bruce; Na, Fu; Zheng, Richard

2008-01-01

This paper reports results from a "natural experiment" taking place in China on the impact of dogs on owners' health. Previous Western research has reported modest health benefits, but results have remained controversial. In China pets were banned in urban areas until 1992. Since then dog ownership has grown quite rapidly in the major…

Information Technologies as Health Management Tools: Urban Elders' Interest and Ability in Using the Internet

ERIC Educational Resources Information Center

Cresci, M. Kay; Novak, Julie M.

2012-01-01

Older adults represent an increasing percentage of both the whole U.S. population and persons living with one or more chronic health conditions. However, extant research has largely overlooked older adults when examining current Internet users and the potential for the Internet as a health management resource. In this study, the researchers…

Health Care among the Kumiai Indians of Baja California, Mexico: Structural and Social Barriers

ERIC Educational Resources Information Center

Fleuriet, K. Jill

2009-01-01

In this article, the author documents the illness and health care problems facing indigenous communities in Baja California, Mexico, by using ethnographic data from research she conducted from 1999 to 2001 with rural, indigenous Kumiai and with their primary health care providers in urban Ensenada. The author contends that barriers to care are…

Perspectives on urban conditions and population health.

PubMed

Vlahov, David; Galea, Sandro; Gibble, Emily; Freudenberg, Nicholas

2005-01-01

The majority of the world's population will live in cities in the next few years and the pace of urbanization worldwide will continue to accelerate over the coming decades. While the number of megacities is projected to increase, the largest population growth is expected to be in cities of less than one million people. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living affects health, a cogent framework that enables systematic study of urban health across time and place has yet to emerge. Four alternate but complementary approaches to the study of urban health today are presented (urban health penalty, urban health advantage, urban sprawl, and an integrative urban conditions model) followed by three key questions that may help guide the study and practice of urban health in coming decades.

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.

Strategic planning and marketing research for older, inner-city health care facilities: a case study.

PubMed

Wood, V R; Robertson, K R

1992-01-01

Numerous health care facilities, located in downtown metropolitan areas, now find themselves surrounded by a decaying inner-city environment. Consumers may perceive these facilities as "old," and catering to an "urban poor" consumer. These same consumers may, therefore, prefer to patronize more modern facilities located in suburban areas. This paper presents a case study of such a health care facility and how strategic planning and marketing research were conducted in order to identify market opportunities and new strategic directions.

Building partnerships for healthy environments: research, leadership and education.

PubMed

Thompson, Susan; Kent, Jennifer; Lyons, Claudine

2014-12-01

As populations across the globe face an increasing health burden from rising rates of obesity, diabetes and other lifestyle-related diseases, health professionals are collaborating with urban planners to influence city design that supports healthy ways of living. This paper details the establishment and operation of an innovative, interdisciplinary collaboration that brings together urban planning and health. Situated in a built environment faculty at one of Australia's most prestigious universities, the Healthy Built Environments Program (HBEP) partners planning academics, a health non-government organisation, local councils and private planning consultants in a state government health department funded consortium. The HBEP focuses on three strategic areas: research, workforce development and education, and leadership and advocacy. Interdisciplinary research includes a comprehensive literature review that establishes Australian-based evidence to support the development, prioritisation and implementation of healthy built environment policies and practices. Another ongoing study examines the design features, social interventions and locational qualities that positively benefit human health. Formal courses, workshops, public lectures and e-learning develop professional capacity, as well as skills in interdisciplinary practice to support productive collaborations between health professionals and planners. The third area involves working with government and non-government agencies, and the private sector and the community, to advocate closer links between health and the built environment. Our paper presents an overview of the HBEP's major achievements. We conclude with a critical review of the challenges, revealing lessons in bringing health and planning closer together to create health-supportive cities for the 21st century.

MINDMAP: establishing an integrated database infrastructure for research in ageing, mental well-being, and the urban environment.

PubMed

Beenackers, Mariëlle A; Doiron, Dany; Fortier, Isabel; Noordzij, J Mark; Reinhard, Erica; Courtin, Emilie; Bobak, Martin; Chaix, Basile; Costa, Giuseppe; Dapp, Ulrike; Diez Roux, Ana V; Huisman, Martijn; Grundy, Emily M; Krokstad, Steinar; Martikainen, Pekka; Raina, Parminder; Avendano, Mauricio; van Lenthe, Frank J

2018-01-19

Urbanization and ageing have important implications for public mental health and well-being. Cities pose major challenges for older citizens, but also offer opportunities to develop, test, and implement policies, services, infrastructure, and interventions that promote mental well-being. The MINDMAP project aims to identify the opportunities and challenges posed by urban environmental characteristics for the promotion and management of mental well-being and cognitive function of older individuals. MINDMAP aims to achieve its research objectives by bringing together longitudinal studies from 11 countries covering over 35 cities linked to databases of area-level environmental exposures and social and urban policy indicators. The infrastructure supporting integration of this data will allow multiple MINDMAP investigators to safely and remotely co-analyse individual-level and area-level data. Individual-level data is derived from baseline and follow-up measurements of ten participating cohort studies and provides information on mental well-being outcomes, sociodemographic variables, health behaviour characteristics, social factors, measures of frailty, physical function indicators, and chronic conditions, as well as blood derived clinical biochemistry-based biomarkers and genetic biomarkers. Area-level information on physical environment characteristics (e.g. green spaces, transportation), socioeconomic and sociodemographic characteristics (e.g. neighbourhood income, residential segregation, residential density), and social environment characteristics (e.g. social cohesion, criminality) and national and urban social policies is derived from publically available sources such as geoportals and administrative databases. The linkage, harmonization, and analysis of data from different sources are being carried out using piloted tools to optimize the validity of the research results and transparency of the methodology. MINDMAP is a novel research collaboration that is combining population-based cohort data with publicly available datasets not typically used for ageing and mental well-being research. Integration of various data sources and observational units into a single platform will help to explain the differences in ageing-related mental and cognitive disorders both within as well as between cities in Europe, the US, Canada, and Russia and to assess the causal pathways and interactions between the urban environment and the individual determinants of mental well-being and cognitive ageing in older adults.

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.

Understanding Urban Green Space as a Health Resource: A Qualitative Comparison of Visit Motivation and Derived Effects among Park Users in Sheffield, UK

PubMed Central

Irvine, Katherine N.; Warber, Sara L.; Devine-Wright, Patrick; Gaston, Kevin J.

2013-01-01

With increasing interest in the use of urban green space to promote human health, there is a need to understand the extent to which park users conceptualize these places as a resource for health and well-being. This study sought to examine park users’ own reasons for and benefits from green space usage and compare these with concepts and constructs in existing person-environment-health theories and models of health. Conducted in 13 public green spaces in Sheffield, UK, we undertook a qualitative content analysis of 312 park users’ responses to open-ended interview questions and identified a breadth, depth and salience of visit motivators and derived effects. Findings highlight a discrepancy between reasons for visiting and derived effects from the use of urban green space. Motivations emphasized walking, green space qualities, and children. Derived effects highlighted relaxation, positive emotions within the self and towards the place, and spiritual well-being. We generate a taxonomy of motivations and derived effects that could facilitate operationalization within empirical research and articulate a conceptual framework linking motivators to outcomes for investigating green space as a resource for human health and well-being. PMID:23340602

Understanding urban green space as a health resource: a qualitative comparison of visit motivation and derived effects among park users in Sheffield, UK.

PubMed

Irvine, Katherine N; Warber, Sara L; Devine-Wright, Patrick; Gaston, Kevin J

2013-01-22

With increasing interest in the use of urban green space to promote human health, there is a need to understand the extent to which park users conceptualize these places as a resource for health and well-being. This study sought to examine park users' own reasons for and benefits from green space usage and compare these with concepts and constructs in existing person-environment-health theories and models of health. Conducted in 13 public green spaces in Sheffield, UK, we undertook a qualitative content analysis of 312 park users' responses to open-ended interview questions and identified a breadth, depth and salience of visit motivators and derived effects. Findings highlight a discrepancy between reasons for visiting and derived effects from the use of urban green space. Motivations emphasized walking, green space qualities, and children. Derived effects highlighted relaxation, positive emotions within the self and towards the place, and spiritual well-being. We generate a taxonomy of motivations and derived effects that could facilitate operationalization within empirical research and articulate a conceptual framework linking motivators to outcomes for investigating green space as a resource for human health and well-being.

Urban photogrammetric data base for multi-purpose cadastral-based information systems: the Riyadh city case

NASA Astrophysics Data System (ADS)

Al-garni, Abdullah M.

Urban information systems are economic resources that can benefit decision makers in the planning, development, and management of urban projects and resources. In this research, a conceptual model-based prototype Urban Geographic Information System (UGIS) is developed. The base maps used in developing the system and acquiring visual attributes are obtained from aerial photographs. The system is a multi-purpose parcel-based one that can serve many urban applications such as public utilities, health centres, schools, population estimation, road engineering and maintenance, and many others. A modern region in the capital city of Saudi Arabia is used for the study. The developed model is operational for one urban application (population estimation) and is tested for that particular application. The results showed that the system has a satisfactory accuracy and that it may well be promising for other similar urban applications in countries with similar demographic and social characteristics.

Neighbourhood Environmental Attributes Associated with Walking in South Australian Adults: Differences between Urban and Rural Areas

PubMed Central

Coffee, Neil T.; Nolan, Rebecca; Dollman, James; Sugiyama, Takemi

2017-01-01

Although the health benefits of walking are well established, participation is lower in rural areas compared to urban areas. Most studies on walkability and walking have been conducted in urban areas, thus little is known about the relevance of walkability to rural areas. A computer-assisted telephone survey of 2402 adults (aged ≥18 years) was conducted to determine walking behaviour and perceptions of neighbourhood walkability. Data were stratified by urban (n = 1738) and rural (n = 664). A greater proportion of respondents reported no walking in rural (25.8%) compared to urban areas (18.5%). Compared to urban areas, rural areas had lower walkability scores and urban residents reported higher frequency of walking. The association of perceived walkability with walking was significant only in urban areas. These results suggest that environmental factors associated with walking in urban areas may not be relevant in rural areas. Appropriate walkability measures specific to rural areas should be further researched. PMID:28846597

Responsibility for health: personal, social, and environmental.

PubMed

Resnik, D B

2007-08-01

Most of the discussion in bioethics and health policy concerning social responsibility for health has focused on society's obligation to provide access to healthcare. While ensuring access to healthcare is an important social responsibility, societies can promote health in many other ways, such as through sanitation, pollution control, food and drug safety, health education, disease surveillance, urban planning and occupational health. Greater attention should be paid to strategies for health promotion other than access to healthcare, such as environmental and public health and health research.

Suicide in Castellon, 2009-2015: Do sociodemographic and psychiatric factors help understand urban-rural differences?

PubMed

Suso-Ribera, Carlos; Mora-Marín, Rafael; Hernández-Gaspar, Carmen; Pardo-Guerra, Lidón; Pardo-Guerra, María; Belda-Martínez, Adela; Palmer-Viciedo, Ramón

Studies have pointed to rurality as an important factor influencing suicide. Research so far suggests that several sociodemograpic and psychiatric factors might influence urban-rural differences in suicide. Also, their contribution appears to depend on sex and age. Unfortunately, studies including a comprehensive set of explanatory variables altogether are still scare and most studies have failed to present their analyses split by sex and age groups. Also, urban-rural differences in suicide in Spain have been rarely investigated. The present study aimed at explaining rural-urban differences in suicidality in the province of Castellon (Spain). A comprehensive set of sociodemographic and psychiatric factors was investigated and analyses were split by sex and age. The sample comprised all suicides recorded in the province of Castellon from January 2009 to December 2015 (n=343). Sociodemographic data included sex, age, and suicide method. Psychiatric data included the history of mental health service utilization, psychiatric diagnosis, suicide attempts, and psychiatric hospitalization. Consistent with past research, suicide rates were highest in rural areas, especially in men and older people. We also found that urban-rural differences in sociodemographic and psychiatric variables were sensitive to sex and age. Our results indicated that specialized mental health service use and accessibility to suicide means might help understand urban-rural differences in suicide, especially in men. When exploring urban-rural differences as a function of age, general practitioner visits for psychiatric reasons were more frequent in the older age group in rural areas. Study implications for suicide prevention strategies in Spain are discussed. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

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…

Is the Urban Child Health Advantage Declining in Malawi?: Evidence from Demographic and Health Surveys and Multiple Indicator Cluster Surveys.

PubMed

Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine

2018-06-01

In many developing countries including Malawi, health indicators are on average better in urban than in rural areas. This phenomenon has largely prompted Governments to prioritize rural areas in programs to improve access to health services. However, considerable evidence has emerged that some population groups in urban areas may be facing worse health than rural areas and that the urban advantage may be waning in some contexts. We used a descriptive study undertaking a comparative analysis of 13 child health indicators between urban and rural areas using seven data points provided by nationally representative population based surveys-the Malawi Demographic and Health Surveys and Multiple Indicator Cluster Surveys. Rate differences between urban and rural values for selected child health indicators were calculated to denote whether urban-rural differentials showed a trend of declining urban advantage in Malawi. The results show that all forms of child mortality have significantly declined between 1992 and 2015/2016 reflecting successes in child health interventions. Rural-urban comparisons, using rate differences, largely indicate a picture of the narrowing gap between urban and rural areas albeit the extent and pattern vary among child health indicators. Of the 13 child health indicators, eight (neonatal mortality, infant mortality, under-five mortality rates, stunting rate, proportion of children treated for diarrhea and fever, proportion of children sleeping under insecticide-treated nets, and children fully immunized at 12 months) show clear patterns of a declining urban advantage particularly up to 2014. However, U-5MR shows reversal to a significant urban advantage in 2015/2016, and slight increases in urban advantage are noted for infant mortality rate, underweight, full childhood immunization, and stunting rate in 2015/2016. Our findings suggest the need to rethink the policy viewpoint of a disadvantaged rural and much better-off urban in child health programming. Efforts should be dedicated towards addressing determinants of child health in both urban and rural areas.

Are slum dwellers at heightened risk of HIV infection than other urban residents? Evidence from population-based HIV prevalence surveys in Kenya.

PubMed

Madise, Nyovani J; Ziraba, Abdhalah K; Inungu, Joseph; Khamadi, Samoel A; Ezeh, Alex; Zulu, Eliya M; Kebaso, John; Okoth, Vincent; Mwau, Matilu

2012-09-01

In 2008, the global urban population surpassed the rural population and by 2050 more than 6 billion will be living in urban centres. A growing body of research has reported on poor health outcomes among the urban poor but not much is known about HIV prevalence among this group. A survey of nearly 3000 men and women was conducted in two Nairobi slums in Kenya between 2006 and 2007, where respondents were tested for HIV status. In addition, data from the 2008/2009 Kenya Demographic and Health Survey were used to compare HIV prevalence between slum residents and those living in other urban and rural areas. The results showed strong intra-urban differences. HIV was 12% among slum residents compared with 5% and 6% among non-slum urban and rural residents, respectively. Generally, men had lower HIV prevalence than women although in the slums the gap was narrower. Among women, sexual experience before the age of 15 compared with after 19 years was associated with 62% higher odds of being HIV positive. There was ethnic variation in patterns of HIV infection although the effect depended on the current place of residence. Copyright © 2012 Elsevier Ltd. All rights reserved.

Meter-scale Urban Land Cover Mapping for EPA EnviroAtlas Using Machine Learning and OBIA Remote Sensing Techniques

NASA Astrophysics Data System (ADS)

Pilant, A. N.; Baynes, J.; Dannenberg, M.; Riegel, J.; Rudder, C.; Endres, K.

2013-12-01

US EPA EnviroAtlas is an online collection of tools and resources that provides geospatial data, maps, research, and analysis on the relationships between nature, people, health, and the economy (http://www.epa.gov/research/enviroatlas/index.htm). Using EnviroAtlas, you can see and explore information related to the benefits (e.g., ecosystem services) that humans receive from nature, including clean air, clean and plentiful water, natural hazard mitigation, biodiversity conservation, food, fuel, and materials, recreational opportunities, and cultural and aesthetic value. EPA developed several urban land cover maps at very high spatial resolution (one-meter pixel size) for a portion of EnviroAtlas devoted to urban studies. This urban mapping effort supported analysis of relations among land cover, human health and demographics at the US Census Block Group level. Supervised classification of 2010 USDA NAIP (National Agricultural Imagery Program) digital aerial photos produced eight-class land cover maps for several cities, including Durham, NC, Portland, ME, Tampa, FL, New Bedford, MA, Pittsburgh, PA, Portland, OR, and Milwaukee, WI. Semi-automated feature extraction methods were used to classify the NAIP imagery: genetic algorithms/machine learning, random forest, and object-based image analysis (OBIA). In this presentation we describe the image processing and fuzzy accuracy assessment methods used, and report on some sustainability and ecosystem service metrics computed using this land cover as input (e.g., carbon sequestration from USFS iTREE model; health and demographics in relation to road buffer forest width). We also discuss the land cover classification schema (a modified Anderson Level 1 after the National Land Cover Data (NLCD)), and offer some observations on lessons learned. Meter-scale urban land cover in Portland, OR overlaid on NAIP aerial photo. Streets, buildings and individual trees are identifiable.

Integration of health into urban spatial planning through impact assessment: Identifying governance and policy barriers and facilitators

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carmichael, Laurence, E-mail: Laurence.carmichael@uwe.ac.uk; Barton, Hugh; Gray, Selena

This article presents the results of a review of literature examining the barriers and facilitators in integrating health in spatial planning at the local, mainly urban level, through appraisals. Our literature review covered the UK and non UK experiences of appraisals used to consider health issues in the planning process. We were able to identify four main categories of obstacles and facilitators including first the different knowledge and conceptual understanding of health by different actors/stakeholders, second the types of governance arrangements, in particular partnerships, in place and the political context, third the way institutions work, the responsibilities they have andmore » their capacity and resources and fourth the timeliness, comprehensiveness and inclusiveness of the appraisal process. The findings allowed us to draw some lessons on the governance and policy framework regarding the integration of health impact into spatial planning, in particular considering the pros and cons of integrating health impact assessment (HIA) into other forms of impact assessment of spatial planning decisions such as environmental impact assessment (EIA) and strategic environment assessment (SEA). In addition, the research uncovered a gap in the literature that tends to focus on the mainly voluntary HIA to assess health outcomes of planning decisions and neglect the analysis of regulatory mechanisms such as EIA and SEA. - Highlights: Black-Right-Pointing-Pointer Governance and policy barriers and facilitators to the integration of health into urban planning. Black-Right-Pointing-Pointer Review of literature on impact assessment methods used across the world. Black-Right-Pointing-Pointer Knowledge, partnerships, management/resources and processes can impede integration. Black-Right-Pointing-Pointer HIA evaluations prevail uncovering research opportunities for evaluating other techniques.« less

Engaging with peri-urban woodlands in England: the contribution to people's health and well-being and implications for future management.

PubMed

O'Brien, Liz; Morris, Jake; Stewart, Amy

2014-06-12

In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin's ideas of co-construction and Gibson's theory of affordances. We focus on peri-urban woodlands in England as important places where people can interact with nature for health and well-being. Qualitative data were collected in situ via walks in the woods, focus group discussions and photo elicitation, with a sample of 49 people. These methods provide rich data on the wide range of meanings associated with woodlands that can have a perceived impact on people's health and well-being. The findings link to contemporary debates about health, well-being and ecosystem services. We explore the inter-play between attributes of the physical environment and the range of facilities provided to enable access, social interactions and the benefits people attribute to their woodland experiences. We conclude that peri-urban woodlands can clearly contribute to self-reported health and well-being in multiple ways, and that organized activities can be important for those who face barriers to accessing woodlands. A strong message emerging from the research is the opportunity afforded by woodlands for social connections with others, as well as the provision of a range of sensory benefits and opportunities to observe and enjoy seasonal change in woodlands. Mental restoration via connection with nature also emerged as important, confirming previous research.

Engaging with Peri-Urban Woodlands in England: The Contribution to People’s Health and Well-Being and Implications for Future Management

PubMed Central

O’Brien, Liz; Morris, Jake; Stewart, Amy

2014-01-01

In this paper we engage with debates concerning people and their contact with the natural environment as part of everyday life drawing on Irwin’s ideas of co-construction and Gibson’s theory of affordances. We focus on peri-urban woodlands in England as important places where people can interact with nature for health and well-being. Qualitative data were collected in situ via walks in the woods, focus group discussions and photo elicitation, with a sample of 49 people. These methods provide rich data on the wide range of meanings associated with woodlands that can have a perceived impact on people’s health and well-being. The findings link to contemporary debates about health, well-being and ecosystem services. We explore the inter-play between attributes of the physical environment and the range of facilities provided to enable access, social interactions and the benefits people attribute to their woodland experiences. We conclude that peri-urban woodlands can clearly contribute to self-reported health and well-being in multiple ways, and that organized activities can be important for those who face barriers to accessing woodlands. A strong message emerging from the research is the opportunity afforded by woodlands for social connections with others, as well as the provision of a range of sensory benefits and opportunities to observe and enjoy seasonal change in woodlands. Mental restoration via connection with nature also emerged as important, confirming previous research. PMID:24927035

Emerging solutions to the water challenges of an urbanizing world.

PubMed

Larsen, Tove A; Hoffmann, Sabine; Lüthi, Christoph; Truffer, Bernhard; Maurer, Max

2016-05-20

The top priorities for urban water sustainability include the provision of safe drinking water, wastewater handling for public health, and protection against flooding. However, rapidly aging infrastructure, population growth, and increasing urbanization call into question current urban water management strategies, especially in the fast-growing urban areas in Asia and Africa. We review innovative approaches in urban water management with the potential to provide locally adapted, resource-efficient alternative solutions. Promising examples include new concepts for stormwater drainage, increased water productivity, distributed or on-site treatment of wastewater, source separation of human waste, and institutional and organizational reforms. We conclude that there is an urgent need for major transdisciplinary efforts in research, policy, and practice to develop alternatives with implications for cities and aquatic ecosystems alike. Copyright © 2016, American Association for the Advancement of Science.

Women's health care: the experiences and behaviors of rural and urban lesbians in the USA.

PubMed

Barefoot, K Nikki; Warren, Jacob C; Smalley, K Bryant

2017-01-01

Previous research has consistently demonstrated that, in comparison to their cisgender heterosexual counterparts, lesbians face a multitude of women's healthcare-related disparities. However, very little research has been conducted that takes an intersectionality approach to examining the potential influences of rural-urban location on the health-related needs and experiences of lesbians. The purpose of this study was to quantitatively compare rural and urban lesbians' access to women's health care, experiences with women's healthcare providers (WHCPs), and preventive behavior using a large, diverse sample of lesbians from across the USA. A total of 895 (31.1% rural and 68.9% urban) lesbian-identified cisgender women (ie not transgender) from the USA participated in the current online study. As part of a larger parent study, participants were recruited from across the USA through email communication to lesbian, gay, bisexual, and transgender (LGBT)-focused organizations and online advertisements. Participants were asked to complete a series of questions related to their women's healthcare-related experiences and behaviors (ie access to care, experiences with WHCPs, and preventive behavior). A series of χ2 analyses were utilized in order to examine rural-urban differences across dependent variables. An examination of sexual risks revealed that relatively more rural lesbians reported at least one previous male sexual partner in comparison to the urban sample of lesbians (78.1% vs 69.1%, χ2(1, N=890)=7.56, p=0.006). A similarly low percentage of rural (42.4%) and urban (42.9%) lesbians reported that they have a WHCP that they see on a regular basis for preventive care. In terms of experiences with WHCP providers, relatively fewer rural lesbians indicated that their current WHCP had discussed/recommended the human papillomavirus (HPV) vaccination in comparison to urban lesbians (27.5% vs. 37.2%; χ2 (1, N=796)=7.24, p=0.007). No other rural-urban differences in experiences with WHCPs emerged - few rural and urban lesbians had been asked about their sexual orientation by their WHCP (38.8% and 45.0%, respectively), been provided with appropriate safe-sex education by their WHCP (21.4% and 25.3%), had their last HIV/sexually transmitted infection screening instigated by their WHCP (if applicable; 15.7% and 19.5%), and reported that their WHCP seems knowledgeable about lesbian health concerns (56.5% vs 54.6%). In terms of preventive behavior, significantly fewer rural lesbians aged 40 years or more had received a mammogram in the past 3 years (63.2% vs 83.2%; χ2(1, N=163)=8.36, p=0.004) when compared to their urban counterparts. No other significant rural-urban differences in preventive behaviors emerged. A similarly low percentage of rural and urban lesbians indicated that they have received the HPV vaccination (22.8% and 29.0%, respectively) and/or have had a HIV/STI screening (43.0% and 47.8%), Pap test (62.0% and 64.5%) or breast exam (59.2% and 62.8%), in the past 3 years. The current findings highlight that rural lesbians in the USA, in comparison to urban lesbians, may experience elevated health risks related to being more likely to have at least one previous male sexual partner, less likely to be recommended the HPV vaccination by a WHCP, and, for those 40 or older, less likely to receive routine mammogram screenings. Furthermore, rural lesbians appear to engage in similarly low rates of HPV vaccination and regular HIV/STI screenings, Pap tests, and clinical breast exams as their urban counterparts. Given the increased cervical and breast cancer risks associated with rural living, the current findings underscore the dire need for health promotion efforts aimed at increasing rural lesbians' engagement in routine pelvic and breast exams.

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

Student Development in an Experiential Learning Program

ERIC Educational Resources Information Center

Gilbert, Brandi L.; Banks, Julianna; Houser, John H. W.; Rhodes, Simon J.; Lees, N. Douglas

2014-01-01

This study is an outcomes assessment of an experiential learning program for undergraduate students interested in life and health sciences careers enrolled at a public urban research institution. The year-long research and professional experience internships were projected to improve learning outcomes in undergraduates. The study included an…

Use of surrogate indicators for the evaluation of potential health risks due to poor urban water quality: A Bayesian Network approach.

PubMed

Wijesiri, Buddhi; Deilami, Kaveh; McGree, James; Goonetilleke, Ashantha

2018-02-01

Urban water pollution poses risks of waterborne infectious diseases. Therefore, in order to improve urban liveability, effective pollution mitigation strategies are required underpinned by predictions generated using water quality models. However, the lack of reliability in current modelling practices detrimentally impacts planning and management decision making. This research study adopted a novel approach in the form of Bayesian Networks to model urban water quality to better investigate the factors that influence risks to human health. The application of Bayesian Networks was found to enhance the integration of quantitative and qualitative spatially distributed data for analysing the influence of environmental and anthropogenic factors using three surrogate indicators of human health risk, namely, turbidity, total nitrogen and fats/oils. Expert knowledge was found to be of critical importance in assessing the interdependent relationships between health risk indicators and influential factors. The spatial variability maps of health risk indicators developed enabled the initial identification of high risk areas in which flooding was found to be the most significant influential factor in relation to human health risk. Surprisingly, population density was found to be less significant in influencing health risk indicators. These high risk areas in turn can be subjected to more in-depth investigations instead of the entire region, saving time and resources. It was evident that decision making in relation to the design of pollution mitigation strategies needs to account for the impact of landscape characteristics on water quality, which can be related to risk to human health. Copyright © 2017 Elsevier Ltd. All rights reserved.

The ADDOPT study (Acupuncture to Decrease Disparities in Outcomes of Pain Treatment): feasibility of offering acupuncture in the community health center setting.

PubMed

McKee, M Diane; Kligler, Benjamin; Blank, Arthur E; Fletcher, Jason; Jeffres, Anne; Casalaina, William; Biryukov, Francesca

2012-09-01

This article describes the feasibility and acceptability of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, which incorporates acupuncture as an adjunct to usual treatment for chronic pain in urban health centers. The study assessed feasibility (ability to carry out in real-world practice; adequacy of resources; acceptability to patients, acupuncturists, and primary care clinicians). Four (4) community health centers in the Bronx, NY, participating in the New York City Research and Improvement Networking Group (NYC RING), a practice-based research network dedicated to decreasing health disparities through primary care research and quality improvement in the urban safety net setting, were involved. The subjects comprised participants receiving care for chronic pain due to osteoarthritis, or neck or back pain at four Bronx health centers serving low-income families. The intervention involved up to 14 weekly acupuncture treatments. Pain and functional status are assessed during a 6-week run-in period before, during, and postacupuncture treatment using the Brief Pain Inventory and the 12-Item Short Form Health Survey. This article reports on baseline status, referral and recruitment, engagement with treatment, and delivery of the intervention across sites. Of 400 patients referred, 185 have initiated treatment. The majority of attending physicians have referred, most commonly for back pain (n=103; 60.6%). Participants' average age is 53.9 (standard deviation [SD] 14.1); 54.1% are Hispanic; and 57.6% are on Medicaid. Half (48%) report "poor" or "fair" overall health. Patients report an average disability score of 74 (SD 27.0) and baseline pain severity on the Brief Pain Inventory of 6 (SD 1.9). Patients have completed a mean of 8.0 (SD 4.7) treatments; 72.4% complete >5 sessions. Clinicians in this urban setting have incorporated acupuncture into chronic pain management. Despite disability and lack of familiarity, patients initiate acupuncture and show high levels of engagement with treatment.

Remediation following Man-made or Natural Disasters -Homeland Security Research

EPA Pesticide Factsheets

EPA develops procedures mitigate contamination and to remediate the environment following public health and environmental incidents and disasters. Contamination incidents involving urban areas could require the decontamination of

Exploring Identities to Deepen Understanding of Urban High School Students' Sexual Health Decision-Making

ERIC Educational Resources Information Center

Brotman, Jennie S.; Mensah, Felicia Moore; Lesko, Nancy

2010-01-01

Sexual health is a controversial science topic that has received little attention in the field of science education, despite its direct relevance to students' lives and communities. Moreover, research from other fields indicates that a great deal remains to be learned about how to make school learning about sexual health influence the real-life…

Cities and health: history, approaches, and key questions.

PubMed

Vlahov, David; Gibble, Emily; Freudenberg, Nicholas; Galea, Sandro

2004-12-01

The majority of the world's population will live in cities in the next few years, and the pace of urbanization worldwide will continue to accelerate over the coming decades. Such a dramatic demographic shift can be expected to have an impact on population health. Although there has been historic interest in how city living is associated with health, this interest has waxed and waned and a cogent framework has yet to evolve that encompasses key issues in urban health. In this article, the authors discuss three alternate approaches to the study of urban health today; these include considering urban health from the perspective of a presumed urban health penalty, from an urban sprawl perspective, and more comprehensively, considering how urban living conditions may be associated with health. The authors also propose three key questions that may help guide the study and practice of urban health in coming decades. These include considering what specific features of cities are causally related to health, the extent to which these features are unique to a particular city or are different between cities, and ultimately, to what extent these features of cities are modifiable in order to allow interventions that can improve the health of urban populations.

Study protocol for the Cities Changing Diabetes programme: a global mixed-methods approach.

PubMed

Napier, A David; Nolan, John J; Bagger, Malene; Hesseldal, Louise; Volkmann, Anna-Maria

2017-11-08

Urban living has been shown to affect health in various ways. As the world is becoming more urbanised and almost two-thirds of people with diabetes now live in cities, research into the relationship between urban living, health and diabetes is key to improving the lives of many. The majority of people with diabetes have type 2 diabetes, a subset linked to overweight and obesity, decreased physical activity and unhealthy diets. Diabetes has significant consequences for those living with the condition as well as their families, relationships and wider society. Although care and management are improving, complications remain common, and diabetes is among the leading causes of vision loss, amputation, neuropathy and renal and cardiovascular disease worldwide. We present a research protocol for exploring the drivers of type 2 diabetes and its complications in urban settings through the Cities Changing Diabetes (CCD) partnership programme. A global study protocol is implemented in eight collaborating CCD partner cities. In each city, academic institutions, municipal representatives and local stakeholders collaborate to set research priorities and plan implementation of findings. Local academic teams execute the study following the global study protocol presented here. A quantitative Rule of Halves analysis obtains measures of the magnitude of the diabetes burden, the diagnosis rates in each city and the outcomes of care. A qualitative Diabetes Vulnerability Assessment explores the urban context in vulnerability to type 2 diabetes and identifies social factors and cultural determinants relevant to health, well-being and diabetes. The protocol steers the collection of primary and secondary data across the study sites. Research ethics board approval has been sought and obtained in each site. Findings from each of the local studies as well as the result from combined multisite (global) analyses will be reported in a series of core scientific journal papers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Neighborhood Environment and Intimate Partner Violence: a systematic review

PubMed Central

Beyer, Kirsten; Wallis, Anne Baber; Hamberger, L. Kevin

2015-01-01

Intimate partner violence (IPV) is an important global public health problem, affecting women across the lifespan and increasing risk for a number of unfavorable health outcomes. Typically conceptualized as a private form of violence, most research has focused on individual-level risk markers. Recently, more scholarly attention has been paid to the role that the residential neighborhood environment may play in influencing the occurrence of IPV. With research accumulating since the 1990s, increasing prominence of the topic, and no comprehensive literature reviews yet undertaken, it is time to take stock of what is known, what remains unknown, and the methods and concepts investigators have considered. In this paper, we undertake a comprehensive, systematic review of the literature to date on the relationship between neighborhood environment and IPV, asking: “What is the status of scholarship related to the association between neighborhood environment and IPV occurrence?” Although the literature is young, it is receiving increasing attention from researchers in sociology, public health, criminology, and other fields. Obvious gaps in the literature include limited consideration of non-urban areas, limited theoretical motivation, and limited consideration of the range of potential contributors to environmental effects on IPV – such as built environmental factors or access to services. In addition, explanations of the pathways by which place influences the occurrence of IPV draw mainly from social disorganization theory, which was developed in urban settings in the United States and may need to be adapted, especially to be useful in explaining residential environmental correlates of IPV in rural or non-US settings. A more complete theoretical understanding of the relationship between neighborhood environment and IPV, especially considering differences among urban, semi-urban and rural settings, and developed and developing country settings, will be necessary to advance research questions and improve policy and intervention responses to reduce the burden of IPV. PMID:24370630

Urban Heat Islands

NASA Technical Reports Server (NTRS)

Luvall, Jeffrey C.; Quattrochi, Dale A.; Rickman, Doug L.; Estes, Maury G.

2011-01-01

It is estimated that by the year 2025, 80% of the world's population will live in cities. This conversion of the natural landscape vegetation into man-made urban structures such as roads and buildings drastically alter the regional surface energy budgets, hydrology, precipitation patterns, and meteorology. Research studies from many cities have documented these effects range from decreases in air quality, increased energy consumption and alteration of regional climate to direct effects on human health.

Disparities in the access to primary healthcare in rural areas from the county of Iasi - Romania.

PubMed

Duma, Olga-Odetta; Roşu, Solange Tamara; Manole, M; Petrariu, F D; Constantin, Brânduşa

2014-01-01

To identify the factors that may conduct to various forms of social exclusion of the population from the primary healthcare and to analyze health disparities as population-specific differences in the access to primary healthcare in rural compared to urban residence areas from Iasi, the second biggest county, situated in the North--East region of Romania. This research is a type of inquiry-based opinion survey of the access to primary healthcare in rural compared to urban areas of the county of Iasi. Data were collected by face-to-face interviews. There were taken into account the socioeconomic status (education level in the adult population, employment status, family income, household size) and two temporal variables (the interval of time spent to arrive at the primary healthcare office as a marker for the geographical access and the waiting time for a consultation). The study group consisted of two samples, from rural and urban area, each of 150 patients, all ages, randomly selected, who were waiting at the family doctor's practice. The study has identified disparities related to a poor economic status assessed through the employed status ("not working" 15% in urban and of 20% in rural).The income calculated per member of family and divided in terciles has recorded significant differences for "high" (36.7% urban and 14.7% rural) and "low", respectively (14.6% urban and 56.6% rural). High household size with more than five members represented 22.6% of the total subjects in rural and 15.3% in urban areas. The assessment of the education level in the adult population (> 18 years) revealed that in the rural areas more than a half (56%) of the sample is placed in the category primary and secondary incomplete, whereas the value for secondary complete and postsecondary was 37.3%. The proportion of respondents in the urban areas who have post-secondary education is five times higher than those in rural areas (15.4% vs. 2.7%). The reduced geographical access assessed as the interval of time spent to arrive at the primary healthcare office revealed, on average, 25 minutes in urban versus 75 minutes in rural areas. The research outcomes highlight the fact that the population living in rural communities from the county of Iasi, are disadvantaged in accessing the primary health services, with negative consequences on the health status.

Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission across Seven Diverse ICEMR Network Sites

PubMed Central

Wilson, Mark L.; Krogstad, Donald J.; Arinaitwe, Emmanuel; Arevalo-Herrera, Myriam; Chery, Laura; Ferreira, Marcelo U.; Ndiaye, Daouda; Mathanga, Don P.; Eapen, Alex

2015-01-01

A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission. PMID:26259941

The role of urban municipal governments in reducing health inequities: A meta-narrative mapping analysis

PubMed Central

2010-01-01

Background The 1986 Ottawa Charter for Health Promotion coincided with a preponderance of research, worldwide, on the social determinants of health and health inequities. Despite the establishment of a 'health inequities knowledge base', the precise roles for municipal governments in reducing health inequities at the local level remain poorly defined. The objective of this study was to monitor thematic trends in this knowledge base over time, and to track scholarly prescriptions for municipal government intervention on local health inequities. Methods Using meta-narrative mapping, four bodies of scholarly literature - 'health promotion', 'Healthy Cities', 'population health' and 'urban health' - that have made substantial contributions to the health inequities knowledge base were analyzed over the 1986-2006 timeframe. Article abstracts were retrieved from the four literature bodies using three electronic databases (PubMed, Sociological Abstracts, Web of Science), and coded for bibliographic characteristics, article themes and determinants of health profiles, and prescriptions for municipal government interventions on health inequities. Results 1004 journal abstracts pertaining to health inequities were analyzed. The overall quantity of abstracts increased considerably over the 20 year timeframe, and emerged primarily from the 'health promotion' and 'population health' literatures. 'Healthy lifestyles' and 'healthcare' were the most commonly emphasized themes in the abstracts. Only 17% of the abstracts articulated prescriptions for municipal government interventions on local health inequities. Such interventions included public health campaigns, partnering with other governments and non-governmental organizations for health interventions, and delivering effectively on existing responsibilities to improve health outcomes and reduce inequities. Abstracts originating from Europe, and from the 'Healthy Cities' and 'urban health' literatures, were most vocal regarding potential avenues for municipal government involvement on health inequities. Conclusions This study has demonstrated a pervasiveness of 'behavioural' and 'biomedical' perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community. Thus, despite considerable research activity over the past two decades, the 'health inequities knowledge base' inadequately reflects the complex aetiology of, and solutions to, population health inequities. PMID:20500850

Urban health in Johannesburg: the importance of place in understanding intra-urban inequalities in a context of migration and HIV.

PubMed

Vearey, Joanna; Palmary, Ingrid; Thomas, Liz; Nunez, Lorena; Drimie, Scott

2010-07-01

Developing country urban contexts present multiple challenges to those responsible for ensuring the good health of urban populations. These include urban growth, migration, informal settlements, intra-urban inequalities and - in some cases - high HIV prevalence. Using Johannesburg as a case study, this paper explores the complexities of the urban context by comparing the social determinants of urban health between migrant groups residing in the inner-city and a peripheral urban informal settlement. It is argued that any attempt to improve the health of urban populations in the context of migration and HIV requires understanding that 'place matters'. 2010 Elsevier Ltd. All rights reserved.

Addressing socioeconomic and political challenges posed by climate change

NASA Astrophysics Data System (ADS)

Fernando, Harindra Joseph; Klaic, Zvjezdana Bencetic

2011-08-01

NATO Advanced Research Workshop: Climate Change, Human Health and National Security; Dubrovnik, Croatia, 28-30 April 2011; Climate change has been identified as one of the most serious threats to humanity. It not only causes sea level rise, drought, crop failure, vector-borne diseases, extreme events, degradation of water and air quality, heat waves, and other phenomena, but it is also a threat multiplier wherein concatenation of multiple events may lead to frequent human catastrophes and intranational and international conflicts. In particular, urban areas may bear the brunt of climate change because of the amplification of climate effects that cascade down from global to urban scales, but current modeling and downscaling capabilities are unable to predict these effects with confidence. These were the main conclusions of a NATO Advanced Research Workshop (ARW) sponsored by the NATO Science for Peace and Security program. Thirty-two invitees from 17 counties, including leading modelers; natural, political, and social scientists; engineers; politicians; military experts; urban planners; industry analysts; epidemiologists; and health care professionals, parsed the topic on a common platform.

Urban Congolese Refugees in Kenya: The Contingencies of Coping and Resilience in a Context Marked by Structural Vulnerability.

PubMed

Tippens, Julie A

2017-06-01

The global increase in refugee migration to urban areas creates challenges pertaining to the promotion of refugee health, broadly conceived. Despite considerable attention to trauma and forced migration, there is relatively little focus on how refugees cope with stressful situations, and on the determinants that facilitate and undermine resilience. This article examines how urban Congolese refugees in Kenya promote psychosocial well-being in the context of structural vulnerability. This article is based on interviews ( N = 55) and ethnographic participant observation with Congolese refugees over a period of 8 months in Nairobi in 2014. Primary stressors related to scarcity of material resources, political and personal insecurity, and emotional stress. Congolese refugees mitigated stressors by (a) relying on faith in God's plan and trust in religious community, (b) establishing borrowing networks, and (c) compartmentalizing the past and present. This research has broader implications for the promotion of urban refugees' psychosocial health and resilience in countries of first asylum.

Pregnancy risk during menstrual cycle: misconceptions among urban men in India.

PubMed

Verma, Prashant; Singh, Kaushalendra Kumar; Singh, Anjali

2017-06-12

In India, where men take most decisions in the family, it is useful that they have adequate knowledge about pregnancy risks during women's menstrual cycles. Since traditional contraceptive methods are still employed by a large population in India, the knowledge regarding the pregnancy risk during the menstrual cycle is indispensable. This research paper attempts to assess the knowledge among urban men in Uttar Pradesh, India about the fertile window of the menstrual cycle; it also attempts to discover the rationales behind the misconceptions about the concept. This study utilizes the baseline data of the Measurement, Learning, and Evaluation project for the Urban Reproductive Health Initiative in Uttar Pradesh. Descriptive Statistics has been used to assess the prevalence of knowledge among urban men regarding the concept. Using the Discriminant Analysis, we also investigate the rationales behind the misconceptions among urban men about the concept. Only one-fifth of the men have the correct knowledge about the concept. Further, we find that education, societal perception, caste, and spousal discussion about the reproductive issues are the primary factors affecting the knowledge about the pregnancy risk during the menstrual cycle. There is an urgent need for sex education in the region to make the urban men more educated about the reproductive process of women; this may reduce unwanted births and abortion due to an unwanted pregnancy as well. The study promotes the higher education and motivates couples to discuss the reproductive health issues among them. In this manner, we can provide better reproductive health to the women of urban India.

Using Formative Research to Design a Behavior Change Strategy to Increase the Use of Improved Cookstoves in Peri-Urban Kampala, Uganda

PubMed Central

Martin, Stephanie L.; Arney, Jennifer K.; Mueller, Lisa M.; Kumakech, Edward; Walugembe, Fiona; Mugisha, Emmanuel

2013-01-01

Household air pollution from cooking with biomass fuels negatively impacts maternal and child health and the environment, and contributes to the global burden of disease. In Uganda, nearly 20,000 young children die of household air pollution-related pneumonia every year. Qualitative research was used to identify behavioral determinants related to the acquisition and use of improved cookstoves in peri-urban Uganda. Results were used to design a behavior change strategy for the introduction of a locally-fabricated top-lit updraft gasifier (TLUD) stove in Wakiso district. A theoretical framework—opportunity, ability, and motivation—was used to guide the research and behavior change strategy development. Participants consistently cited financial considerations as the most influential factor related to improved cookstove acquisition and use. In contrast, participants did not prioritize the potential health benefits of improved cookstoves. The theoretical framework, research methodology, and behavior change strategy design process can be useful for program planners and researchers interested in identifying behavioral determinants and designing and evaluating improved cookstove interventions. PMID:24336020

Frontline staff motivation levels and health care quality in rural and urban primary health facilities: a baseline study in the Greater Accra and Western regions of Ghana.

PubMed

Alhassan, Robert Kaba; Nketiah-Amponsah, Edward

2016-12-01

The population of Ghana is increasingly becoming urbanized with about 70 % of the estimated 26.9 million people living in urban and peri-urban areas. Nonetheless, eight out of the ten regions in Ghana remain predominantly rural where only 32.1 % of the national health sector workforce works. Doctor-patient ratio in a predominantly rural region is about 1:18,257 compared to 1:4,099 in an urban region. These rural-urban inequities significantly account for the inability of Ghana to attain the health related Millennium Development Goals (MDGs) before the end of 2015. To ascertain whether or not rural-urban differences exist in health worker motivation levels and quality of health care in health facilities accredited by the National Health Insurance Authority in Ghana. This is a baseline quantitative study conducted in 2012 among 324 health workers in 64 accredited clinics located in 9 rural and 7 urban districts in Ghana. Ordered logistic regression was performed to determine the relationship between facility geographic location (rural/urban) and staff motivation levels, and quality health care standards. Quality health care and patient safety standards were averagely low in the sampled health facilities. Even though health workers in rural facilities were more de-motivated by poor availability of resources and drugs than their counterparts in urban facilities (p < 0.05), quality of health care and patient safety standards were relatively better in rural facilities. For Ghana to attain the newly formulated sustainable development goals on health, there is the need for health authorities to address the existing rural-urban imbalances in health worker motivation and quality health care standards in primary healthcare facilities. Future studies should compare staff motivation levels and quality standards in accredited and non-accredited health facilities since the current study was limited to health facilities accredited by the National Health Insurance Authority.

Mitigation: Decarbonization unique to cities

NASA Astrophysics Data System (ADS)

Ibrahim, Nadine

2017-10-01

Strategies that reduce fossil-fuel use can achieve both global carbon mitigation and local health-protection goals. Now research shows the dual benefits of compact urban design and circular economy policies in Chinese cities.

Forest Service Global Change Research Strategy, 2009-2019

Treesearch

Allen Solomon; Richard Birdsey; Linda A. Joyce; Jennifer Hayes

2009-01-01

In keeping with the research goals of the U.S. Climate Change Science Program, the Research and Development agenda of the Forest Service, U.S. Department of Agriculture (USDA), helps define climate change policy and develop best management practices for forests (both rural and urban) and grasslands. These actions are taken to sustain ecosystem health, adjust management...

Attitudes and beliefs toward biobehavioural research participation: voices and concerns of urban adolescent females receiving outpatient mental health treatment

PubMed Central

Brawner, Bridgette M.; Volpe, Ellen M.; Stewart, Jennifer M.; Gomes, Melissa M.

2015-01-01

Background Biobehavioural research methodology can be invasive and burdensome for participants—particularly adolescents with mental illnesses. Human biological researchers should consider how methodological impositions may hinder adolescent research participation. However, literature on adolescent’s voices and concerns toward biobehavioural research participation is virtually non-existent. Aim This study was designed to determine adolescents’ perceptions of participation in research involving the collection of biomarkers via blood, saliva and/or urine samples. Subjects and methods Urban adolescent females (aged 12–19) receiving outpatient mental health treatment (n = 37) participated in focus groups with concurrent survey administration to explore attitudes, beliefs and willingness/intentions toward biobehavioural research participation. Results Participants had favourable attitudes toward biobehavioural research and were amenable to provide each specimen type. Mistrust for research emerged, however, and concerns related to privacy and confidentiality were expressed. Conclusion Participant recruitment is a critical component in study design and implementation; this includes knowledge of population-specific recruitment barriers and facilitators. This innovative paper provides a context for the research participants’ decision-making process, strategies to allay fears and concerns and concrete areas to target in research-related interventions. Although the findings are from a specific, US-based sample, the implications warrant replication of the research in other geosocial settings. PMID:23822716

Attitudes and beliefs toward biobehavioural research participation: voices and concerns of urban adolescent females receiving outpatient mental health treatment.

PubMed

Brawner, Bridgette M; Volpe, Ellen M; Stewart, Jennifer M; Gomes, Melissa M

2013-01-01

Biobehavioural research methodology can be invasive and burdensome for participants - particularly adolescents with mental illnesses. Human biological researchers should consider how methodological impositions may hinder adolescent research participation. However, literature on adolescent's voices and concerns toward biobehavioural research participation is virtually non-existent. This study was designed to determine adolescents' perceptions of participation in research involving the collection of biomarkers via blood, saliva and/or urine samples. Urban adolescent females (aged 12-19) receiving outpatient mental health treatment (n = 37) participated in focus groups with concurrent survey administration to explore attitudes, beliefs and willingness/intentions toward biobehavioural research participation. Participants had favourable attitudes toward biobehavioural research and were amenable to provide each specimen type. Mistrust for research emerged, however, and concerns related to privacy and confidentiality were expressed. Participant recruitment is a critical component in study design and implementation; this includes knowledge of population-specific recruitment barriers and facilitators. This innovative paper provides a context for the research participants' decision-making process, strategies to allay fears and concerns and concrete areas to target in research-related interventions. Although the findings are from a specific, US-based sample, the implications warrant replication of the research in other geosocial settings.

Coping with changing conditions: alternative strategies for the delivery of maternal and child health and family planning services in Dhaka, Bangladesh.

PubMed Central

Routh, S.; el Arifeen, S.; Jahan, S. A.; Begum, A.; Thwin, A. A.; Baqui, A. H.

2001-01-01

The door-to-door distribution of contraceptives and information on maternal and child health and family planning (MCH-FP) services, through bimonthly visits to eligible couples by trained fieldworkers, has been instrumental in increasing the contraceptive prevalence rate and immunization coverage in Bangladesh. The doorstep delivery strategy, however, is labour-intensive and costly. More cost-effective service delivery strategies are needed, not only for family planning services but also for a broader package of reproductive and other essential health services. Against this backdrop, operations research was conducted by the Centre for Health and Population Research at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) from January 1996 to May 1997, in collaboration with government agencies and a leading national nongovernmental organization, with a view to developing and field-testing alternative approaches to the delivery of MCH-FP services in urban areas. Two alternative strategies featuring the withdrawal of home-based distribution and the delivery of basic health care from fixed-site facilities were tested in two areas of Dhaka. The clinic-based service delivery strategy was found to be a feasible alternative to the resource-intensive doorstep system in urban Dhaka. It did not adversely affect programme performance and it allowed the needs of clients to be addressed holistically through a package of essential health and family planning services. PMID:11242821

Impediments and constraints in the uptake of water sensitive urban design measures in greenfield and infill developments.

PubMed

Sharma, Ashok K; Cook, Stephen; Tjandraatmadja, Grace; Gregory, Alan

2012-01-01

Water sensitive urban developments are designed with integrated urban water management concepts and water sensitive urban design measures. The initiatives that may be included are the substitution of imported drinking water with alternative sources using a fit-for-purpose approach and structural and non-structural measures for the source control of stormwater. A water sensitive approach to urban development can help in achieving sustainability objectives by minimising disturbance to ecological and hydrological processes, and also relieve stress on conventional water systems. Water sensitive urban developments remain novel in comparison with conventional approaches, so the understanding and knowledge of the systems in regards to their planning; design; implementation; operation and maintenance; health impacts and environmental impacts is still developing and thus the mainstream uptake of these approaches faces many challenges. A study has been conducted to understand these challenges through a detailed literature review, investigating a large number of local greenfield and infill developments, and conducting extensive consultation with water professionals. This research has identified the social, economic, political, institutional and technological challenges faced in implementing water sensitive urban design in greenfield and infill developments. The research found in particular that there is the need for long-term monitoring studies of water sensitive urban developments. This monitoring is important to validate the performance of novel approaches implemented and improve associated guidelines, standards, and regulatory and governance frameworks, which can lead to mainstream acceptance of water sensitive urban development approaches. The dissemination of this research will help generate awareness among water professionals, water utilities, developers, planners and regulators of the research challenges to be addressed in order to achieve more mainstream acceptance of water sensitive approaches to urban development. This study is based on existing water sensitive urban developments in Australia, however, the methodology adopted in investigating impediments to the uptake of these developments can be applied globally. It is hoped that insights from this study will benefit water professionals in other countries where there is also a move towards water sensitive urban development.

Perceived Risk of Avian Influenza and Urbanization in Northern Vietnam.

PubMed

Finucane, Melissa L; Tuyen, Nghiem; Saksena, Sumeet; Spencer, James H; Fox, Jefferson M; Lam, Nguyen; Thau, Trinh Dinh; Vien, Tran Duc; Lewis, Nancy Davis

2017-03-01

Highly pathogenic avian influenza (HPAI) is an important public health concern because of potential for widespread morbidity and mortality in humans and poultry and associated devastating economic losses. We examined how perceptions of the risk of HPAI in poultry vary across communes/wards in the north of Vietnam at different levels of urbanization (rural, peri-urban, urban). Analyses of questionnaire responses from 1081 poultry raisers suggested that the perceived risk of HPAI in poultry was highest in peri-urban and rural settings. We also found that perceived risk was higher when respondents rated settings in which they did not live and that the process of change is related to perceived risk. Compared with others, respondents in peri-urban areas reported less disease management planning; respondents in rural areas reported less ability to separate infected poultry. These findings are consistent with, and add to, the limited previous research on the perceived risk of HPAI in poultry in developing countries. What is new in the present findings is that we describe how urbanization is related to people's perceptions of and ability to respond appropriately to variations in their environment. In particular, the inability to respond is not necessarily because of an inability to perceive change. Rather, rapid and extensive change poses different challenges for poultry management as communes move from rural to peri-urban to urban settings. Our results suggest that health promotion campaigns should address the perceptions and needs of poultry raisers in different settings.

Why wait so long for child care? An analysis of waits, queues and work in a South African urban health centre.

PubMed

Bachmann, M O; Barron, P

1997-01-01

Long waits at large urban clinics obstruct primary care delivery, imposing time costs on patients, deterring appropriate utilization and causing patient dissatisfaction. This paper reports on an innovative attempt by staff in a large South African urban health centre to analyse a system of queues and preventive and curative services for pre-school children, and thereafter to evaluate changes. The study had a cross-sectional work study design, with repeated measurement of waiting times after 13 months. At baseline the preventive clinic was found to have several inessential processes and waits; these were eliminated or overlapped, and clinic sessions per week were increased. A year later median waiting times had decreased substantially in the preventive clinic, but had increased in the curative clinic. Simple research can explain long waits, inform and measure changes, and provide evidence to justify primary care integration and would be useful in health centres and hospital outpatient departments in developing countries.

A Review of Recent Research on Minneapolis Indians: 1968-1969.

ERIC Educational Resources Information Center

Woods, Richard G.; Harkins, Arthur M.

Research conducted during 1968 and 1969 concerning the Minneapolis Indian population is examined in an attempt to describe their characteristics; their relationship to major urban institutions; their employment, health, and housing; and justice, public welfare, and public institutions as related to the Indian. Inequities in the relationship…

Can the University Forget the Past and Find Happiness in the Present?

ERIC Educational Resources Information Center

Hirsch, Abraham M.

1972-01-01

Outlines a proposal for structuring higher education so that both teaching and research are closely interrelated to particular social issues; for instance, world peace, urban improvement, health, or poverty. Traditional organization based on academic disciplines is considered not relevant to present research or instruction demands. (AL)

[More Health in Urban Districts: The Integration of Health Promotion in Urban Development].

PubMed

Reimann, B; Böhme, C

2015-09-01

Poverty represents a considerable health risk. As social- and health-related disadvantages are spatially concentrated, municipalities must take up the task of forging a stronger link between urban district development and health promotion than has thus far been the case. Moreover, they must put health promotion as part of urban district development as an item on the agenda. The present contribution illustrates in which ways health promotion in disadvantaged urban districts and its scientific monitoring and evaluation can be successful. © Georg Thieme Verlag KG Stuttgart · New York.

The Effects of the Urban Built Environment on Mental Health: A Cohort Study in a Large Northern Italian City

PubMed Central

Melis, Giulia; Gelormino, Elena; Marra, Giulia; Ferracin, Elisa; Costa, Giuseppe

2015-01-01

Mental health (MH) has a relevant burden on the health of populations. Common MH disorders (anxiety and non-psychotic depression) are well associated to socioeconomic individual and neighborhood characteristics, but little is known about the influence of urban structure. We analyzed among a Turin (Northwest Italy) urban population the association at area level of different urban structure characteristics (density, accessibility by public transport, accessibility to services, green and public spaces) and consumption of antidepressants. Estimates were adjusted by individual socio-demographic variables (education, housing tenure, employment) and contextual social environment (SE) variables (social and physical disorder, crime rates). Data was extracted from the Turin Longitudinal Study (TLS)—a census-based cohort study following up prospectively the mortality and morbidity of the population. As expected, individual characteristics show the strongest association with antidepressant drug consumption, while among built environment (BE) indicators accessibility by public transport and urban density only are associated to MH, being slightly protective factors. Results from this study, in agreement with previous literature, suggest that BE has a stronger effect on MH for people who spend more time in the neighborhood. Therefore, this research suggests that good accessibility to public transport, as well as a dense urban structure (versus sprawl), could contribute to reduced risk of depression, especially for women and elderly, by increasing opportunities to move around and have an active social life. PMID:26610540

Way of Life as Emphasizing Factors in the Progression of Idiophatic Scoliosis in Adolescence Era

PubMed Central

Muminagic, Sahib; Bisanovic, Senaida; Mehic, Sanra; Sivic, Suad

2012-01-01

Introduction: Idiopathic scoliosis is a significant health problem which occurs in 2%–4% school kids in adolescent age. Reasons of occurrence are not quite clear, there are many theories, but probably it is multifactor disease. Among the theories that are mentioned some of them included environmental and behavioral factors. Aim: Research the impact of some environmental and behavioral factor on development and progression of idiopathic scoliosis in school kids. Methodology: Research was conducted on 421 pupil in adolescent age, where 120 pupils was from urban schools and 301 pupil from rural schools. Environmental factors and habits like the bigger osteomuscular structure mobility at kids from rural schools, longer outdoor time spending, different nutrition, alcoholism and smoking, different obligations, etc. factors which can be cause of scoliosis development. Results: In this research we assumed that different environmental and behavioral factors of school kids, which exist in rural and urban areas, can develop to different expression of scoliosis in these areas. In our research we proved that the scoliosis occurrence is more often in urban areas than in rural (Fisher’s exact test P<0.001). Conclusion: It is necessary to research all factors of lifestyle individually, which are different between the urban and rural kids. PMID:23678322

The relationship between urban forests and income: A meta-analysis.

PubMed

Gerrish, Ed; Watkins, Shannon Lea

2018-02-01

Urban trees provide substantial public health and public environmental benefits. However, scholarly works suggest that urban trees may be unequally distributed among poor and minority urban communities, meaning that these communities are potentially being deprived of public environmental benefits, a form of environmental injustice. The evidence of this problem is not uniform however, and evidence of inequity varies in size and significance across studies. This variation in results suggests the need for a research synthesis and meta-analysis. We employed a systematic literature search to identify original studies which examined the relationship between urban forest cover and income (n=61) and coded each effect size (n=332). We used meta-analytic techniques to estimate the average (unconditional) relationship between urban forest cover and income and to estimate the impact that methodological choices, measurement, publication characteristics, and study site characteristics had on the magnitude of that relationship. We leveraged variation in study methodology to evaluate the extent to which results were sensitive to methodological choices often debated in the geographic and environmental justice literature but not yet evaluated in environmental amenities research. We found evidence of income-based inequity in urban forest cover (unconditional mean effect size = 0.098; s.e. = .017) that was robust across most measurement and methodological strategies in original studies and results did not differ systematically with study site characteristics. Studies that controlled for spatial autocorrelation, a violation of independent errors, found evidence of substantially less urban forest inequity; future research in this area should test and correct for spatial autocorrelation.

Urban public health assessment and pattern analysis: comparison of four cities in different countries

NASA Astrophysics Data System (ADS)

Su, Meirong; Chen, Chen; Lu, Weiwei; Liu, Gengyuan; Yang, Zhifeng; Chen, Bin

2013-06-01

Urban public health is an important global issue, and receives extensive attention. It is necessary to compare urban public health status among different cities, so that each city can define its own health patterns and limiting factors. The following assessment indicators were established to evaluate urban public health status: living conditions, physical health, education and culture, environmental quality, and social security. A weighted-sum model was used in combination with these indicators to compare the urban public health status in four cities—Beijing, New York, London, and Tokyo—using data for 2000-2009. Although the urban public health level of Beijing was lower than that of the other cities, it showed the greatest increase in this level over the study period. Different patterns of urban public health were identified: London had the most balanced, steady pattern (almost all factors performed well and developed stably); New York and Tokyo showed balanced, but unsteady patterns (most factors remained high, though social security and environmental quality fluctuated); Beijing had the most unbalanced, unsteady pattern (the different factors were at different levels, and education and culture and social security fluctuated). For enhanced urban public health status, environmental quality and education and culture clearly need to be improved in Beijing. This study demonstrates that a comparison of different cities is helpful in identifying limiting factors for urban public health and providing an orientation for future urban development.

Evolution of life in urban environments.

PubMed

Johnson, Marc T J; Munshi-South, Jason

2017-11-03

Our planet is an increasingly urbanized landscape, with over half of the human population residing in cities. Despite advances in urban ecology, we do not adequately understand how urbanization affects the evolution of organisms, nor how this evolution may affect ecosystems and human health. Here, we review evidence for the effects of urbanization on the evolution of microbes, plants, and animals that inhabit cities. Urbanization affects adaptive and nonadaptive evolutionary processes that shape the genetic diversity within and between populations. Rapid adaptation has facilitated the success of some native species in urban areas, but it has also allowed human pests and disease to spread more rapidly. The nascent field of urban evolution brings together efforts to understand evolution in response to environmental change while developing new hypotheses concerning adaptation to urban infrastructure and human socioeconomic activity. The next generation of research on urban evolution will provide critical insight into the importance of evolution for sustainable interactions between humans and our city environments. Copyright © 2017 The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study: research design and methodology.

PubMed

Badland, Hannah M; Schofield, Grant M; Witten, Karen; Schluter, Philip J; Mavoa, Suzanne; Kearns, Robin A; Hinckson, Erica A; Oliver, Melody; Kaiwai, Hector; Jensen, Victoria G; Ergler, Christina; McGrath, Leslie; McPhee, Julia

2009-07-10

Built environment attributes are recognized as being important contributors to physical activity (PA) engagement and body size in adults and children. However, much of the existing research in this emergent public health field is hindered by methodological limitations, including: population and site homogeneity, reliance on self-report measures, aggregated measures of PA, and inadequate statistical modeling. As an integral component of multi-country collaborative research, the Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study seeks to overcome these limitations by determining the strengths of association between detailed measures of the neighborhood built environment with PA levels across multiple domains and body size measures in adults and children. This article outlines the research protocol developed for the URBAN Study. The URBAN Study is a multi-centered, stratified, cross-sectional research design, collecting data across four New Zealand cities. Within each city, 12 neighborhoods were identified and selected for investigation based on higher or lower walkability and Māori demographic attributes. Neighborhoods were selected to ensure equal representation of these characteristics. Within each selected neighborhood, 42 households are being randomly selected and an adult and child (where possible) recruited into the study. Data collection includes: objective and self-reported PA engagement, neighborhood perceptions, demographics, and body size measures. The study was designed to recruit approximately 2,000 adults and 250 children into the project. Other aspects of the study include photovoice, which is a qualitative assessment of built environment features associated with PA engagement, an audit of the neighborhood streetscape environment, and an individualized neighborhood walkability profile centered on each participant's residential address. Multilevel modeling will be used to examine the individual-level and neighborhood-level relationships with PA engagement and body size. The URBAN Study is applying a novel scientifically robust research design to provide urgently needed epidemiological information regarding the associations between the built environment and health outcomes. The findings will contribute to a larger, international initiative in which similar neighborhood selection and PA measurement procedures are utilized across eight countries. Accordingly, this study directly addresses the international priority issues of increasing PA engagement and decreasing obesity levels.

Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study: research design and methodology

PubMed Central

Badland, Hannah M; Schofield, Grant M; Witten, Karen; Schluter, Philip J; Mavoa, Suzanne; Kearns, Robin A; Hinckson, Erica A; Oliver, Melody; Kaiwai, Hector; Jensen, Victoria G; Ergler, Christina; McGrath, Leslie; McPhee, Julia

2009-01-01

Background Built environment attributes are recognized as being important contributors to physical activity (PA) engagement and body size in adults and children. However, much of the existing research in this emergent public health field is hindered by methodological limitations, including: population and site homogeneity, reliance on self-report measures, aggregated measures of PA, and inadequate statistical modeling. As an integral component of multi-country collaborative research, the Understanding the Relationship between Activity and Neighbourhoods (URBAN) Study seeks to overcome these limitations by determining the strengths of association between detailed measures of the neighborhood built environment with PA levels across multiple domains and body size measures in adults and children. This article outlines the research protocol developed for the URBAN Study. Methods and design The URBAN Study is a multi-centered, stratified, cross-sectional research design, collecting data across four New Zealand cities. Within each city, 12 neighborhoods were identified and selected for investigation based on higher or lower walkability and Māori demographic attributes. Neighborhoods were selected to ensure equal representation of these characteristics. Within each selected neighborhood, 42 households are being randomly selected and an adult and child (where possible) recruited into the study. Data collection includes: objective and self-reported PA engagement, neighborhood perceptions, demographics, and body size measures. The study was designed to recruit approximately 2,000 adults and 250 children into the project. Other aspects of the study include photovoice, which is a qualitative assessment of built environment features associated with PA engagement, an audit of the neighborhood streetscape environment, and an individualized neighborhood walkability profile centered on each participant's residential address. Multilevel modeling will be used to examine the individual-level and neighborhood-level relationships with PA engagement and body size. Discussion The URBAN Study is applying a novel scientifically robust research design to provide urgently needed epidemiological information regarding the associations between the built environment and health outcomes. The findings will contribute to a larger, international initiative in which similar neighborhood selection and PA measurement procedures are utilized across eight countries. Accordingly, this study directly addresses the international priority issues of increasing PA engagement and decreasing obesity levels. PMID:19589175

Urban Health Indicator Tools of the Physical Environment: a Systematic Review.

PubMed

Pineo, Helen; Glonti, Ketevan; Rutter, Harry; Zimmermann, Nici; Wilkinson, Paul; Davies, Michael

2018-04-16

Urban health indicator (UHI) tools provide evidence about the health impacts of the physical urban environment which can be used in built environment policy and decision-making. Where UHI tools provide data at the neighborhood (and lower) scale they can provide valuable information about health inequalities and environmental deprivation. This review performs a census of UHI tools and explores their nature and characteristics (including how they represent, simplify or address complex systems) to increase understanding of their potential use by municipal built environment policy and decision-makers. We searched seven bibliographic databases, four key journals and six practitioner websites and conducted Google searches between January 27, 2016 and February 24, 2016 for UHI tools. We extracted data from primary studies and online indicator systems. We included 198 documents which identified 145 UHI tools comprising 8006 indicators, from which we developed a taxonomy. Our taxonomy classifies the significant diversity of UHI tools with respect to topic, spatial scale, format, scope and purpose. The proportions of UHI tools which measure data at the neighborhood and lower scale, and present data via interactive maps, have both increased over time. This is particularly relevant to built environment policy and decision-makers, reflects growing analytical capability and offers the potential for improved understanding of the complexity of influences on urban health (an aspect noted as a particular challenge by some indicator producers). The relation between urban health indicators and health impacts attributable to modifiable environmental characteristics is often indirect. Furthermore, the use of UHI tools in policy and decision-making appears to be limited, thus raising questions about the continued development of such tools by multiple organisations duplicating scarce resources. Further research is needed to understand the requirements of built environment policy and decision-makers, public health professionals and local communities regarding the form and presentation of indicators which support their varied objectives.

Strategic Planning for Recruitment and Retention of Older African Americans in Health Promotion Research Programs.

PubMed

Dreer, Laura E; Weston, June; Owsley, Cynthia

2014-01-01

The purpose of this study was to 1) describe a strategic plan for recruitment and retention used in conducting eye health education research with African-Americans living in urban and rural areas of Alabama and 2) characterize recruitment and retention patterns for this community-based project. We evaluated an eye health education program tailored specifically to older African Americans. InCHARGE© was designed to promote eye disease prevention by conveying the personal benefits of annual, dilated, comprehensive eye care and teaching strategies to minimize barriers to regular eye care. The InCHARGE© program or a social contact control program was delivered at 20 senior centers in predominately African American urban and rural communities. From pooled data across three studies, 380 African Americans completed a questionnaire about knowledge and attitudes/beliefs about eye disease and eye care before the program and by telephone at either 3 or 6 months after the presentation. The project consisted of 4 phases and a total of 10 strategic objectives for recruitment as well as retention of older African Americans that were implemented in a systematic fashion. Overall, retention rates for follow-up at either 3 or 6 months were 75% and 66% respectively. African Americans from rural areas were more likely to be lost to follow-up compared to those from urban areas. We discuss the benefits of utilizing a strategic plan that serves to address problems with underrepresentation of minorities in clinical research.

Psychiatric disorders and urbanization in Germany

PubMed Central

Dekker, Jack; Peen, Jaap; Koelen, Jurrijn; Smit, Filip; Schoevers, Robert

2008-01-01

Background Epidemiological studies over the last decade have supplied growing evidence of an association between urbanization and the prevalence of psychiatric disorders. Our aim was to examine the link between levels of urbanization and 12-month prevalence rates of psychiatric disorders in a nationwide German population study, controlling for other known risk factors such as gender, social class, marital status and the interaction variables of these factors with urbanization. Methods The Munich Composite International Diagnostic Interview (M-CIDI) was used to assess the prevalence of mental disorders (DSM-IV) in a representative sample of the German population (N = 4181, age: 18–65). The sample contains five levels of urbanization based on residence location. The epidemiological study was commissioned by the German Ministry of Research, Education and Science (BMBF) and approved by the relevant Institutional Review Board and ethics committee. Written informed consent was obtained for both surveys (core survey and Mental Health Supplement). Subjects did not get any financial compensation for their study participation. Results Higher levels of urbanization were linked to higher 12-month prevalence rates for almost all major psychiatric disorders (with the exception of substance abuse and psychotic disorders). The weighted prevalence percentages were highest in the most urbanized category. Alongside urbanization, female gender, lower social class and being unmarried were generally found to be associated with higher levels of psychopathology. The impact of urbanization on mental health was about equal (for almost all major psychiatric disorders) in young people and elderly people, men and women, and in married and single people. Only people from a low social class in the most urbanized settings had more somatoform disorders, and unmarried people in the most urbanized settings had more anxiety disorders. Conclusion Psychiatric disorders are more prevalent among the inhabitants of more urbanized areas. probably because of environmental stressors. PMID:18201380

Has the Financial Protection Been Materialized in Iranian Health System? Analyzing Household Income and Expenditure Survey 2003-2014.

PubMed

Ghiasvand, Hesam; Olyaeemanesh, Alireza; Majdzadeh, Reza; Abdi, Zhaleh; Mobinizadeh, Mohammadreza

2018-01-03

The financial protection against catastrophic and impoverishing health expenditures is one of the main aspects of the universal health coverage. This study aimed to present a clear picture of the financial protection situation in Iran from 2003-2014. This is an analytical study on secondary data of Statistical Center of Iran (SCI). The study has some policy implications for policy makers; therefore, it is an applied one. Data related to the Iranian rural and urban household payments on health expenditures was obtained from annual surveys of the SCI. WHO researchers' approach was used to calculate the Fairness of Financial Contribution Indicator (FFCI), the headcount and overshoot ratios of catastrophic and impoverishing health expenditures. A logistic regression was conducted to identify the determinants of probability of occurrence of catastrophic health expenditure among Iranian households in 2014. The mean of FFCI for rural and urban households was 0.854 (0.41) and 0.867 (0.32), respectively. The average headcount ratios of catastrophic and impoverishing health expenditures were 1.32% (0.24) and 0.33% (P=0.006) for rural households and 1.4% (0.6) and 0.28% (P=0.001) for urban households. Concerning rural households, the overshoot of catastrophic and impoverishing health expenditures was 14.94% (P=0.001) and 7.22% (0.53); it was 15.59% (1.54) and 7.76% (0.52) for urban households. No significant and considerable change was found in the headcount ratios of catastrophic and impoverishing health expenditure and in their overshoot or gap amounts. This suggested a lack of well-designed and effective schemes for materializing the financial protection in Iran.

Residential Segregation and Birth Weight among Racial and Ethnic Minorities in the United States

ERIC Educational Resources Information Center

Walton, Emily

2009-01-01

Racial and ethnic minorities are often residentially segregated from whites in urban settings, a fact which has important health consequences. Research on the relationship between residential segregation and health outcomes lacks national-level investigation of racial and ethnic minority groups other than African Americans. I use multilevel…

Parental Education and High School Completion in the Urban Informal Settlements in Kenya

ERIC Educational Resources Information Center

Abuya, Benta A.; Elungata, Patricia; Mutisya, Maurice; Kabiru, Caroline W.

2017-01-01

A well-established empirical association exists between family background and children's educational attainment. Studies have shown the importance of parental education for not just children's educational outcomes but also other behavioral, and health outcomes. In this paper, data collected by African Population and Health Research Center in 2012…

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.

Airborne biological hazards and urban transport infrastructure: current challenges and future directions.

PubMed

Nasir, Zaheer Ahmad; Campos, Luiza Cintra; Christie, Nicola; Colbeck, Ian

2016-08-01

Exposure to airborne biological hazards in an ever expanding urban transport infrastructure and highly diverse mobile population is of growing concern, in terms of both public health and biosecurity. The existing policies and practices on design, construction and operation of these infrastructures may have severe implications for airborne disease transmission, particularly, in the event of a pandemic or intentional release of biological of agents. This paper reviews existing knowledge on airborne disease transmission in different modes of transport, highlights the factors enhancing the vulnerability of transport infrastructures to airborne disease transmission, discusses the potential protection measures and identifies the research gaps in order to build a bioresilient transport infrastructure. The unification of security and public health research, inclusion of public health security concepts at the design and planning phase, and a holistic system approach involving all the stakeholders over the life cycle of transport infrastructure hold the key to mitigate the challenges posed by biological hazards in the twenty-first century transport infrastructure.

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 disability-free life expectancy in Bangladesh using the 2010 HIES data.

PubMed

Islam, Md Shariful; Tareque, Md Ismail; Mondal, Md Nazrul Islam; Fazle Rabbi, Ahbab Mohammad; Khan, Hafiz T A; Begum, Sharifa

2017-01-01

Research on health expectancy has been carried out in Bangladesh but none of it has examined the differences in Disability-Free Life Expectancy (DFLE) between urban and rural setting in context of rapid urbanization of Bangladesh in past decades. The present study aims to estimate DFLE for people of all ages living in urban and rural areas in Bangladesh, and to examine the differences in DFLE between these two areas. Data from the Sample Vital Registration System 2010 and the Bangladesh Household Income and Expenditure Survey (HIES) 2010 were used in this study. The Sullivan method was applied to estimate DFLE in Bangladesh. Higher rates of mortality and disability were observed in rural areas compared to urban areas with few exceptions. Statistically significant differences in DFLE were revealed from birth to age 15 years for both sexes between urban and rural areas. Urban males had a longer life expectancy (LE), longer DFLE and shorter LE with disability both in number and proportion when compared to rural males. Rural females at age 20+ years had a longer LE than urban females but urban females had a longer DFLE and a shorter LE with disability in both number and proportion at all ages than did rural females. This study demonstrates that there were clear inequalities in LE, DFLE and LE with disability between rural and urban areas of Bangladesh along with age-specific differences as well. These findings may serve as useful and benchmark for intervention and policy implications for reducing the gap in health outcomes.

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

Healthcare seeking practices and barriers to accessing under-five child health services in urban slums in Malawi: a qualitative study.

PubMed

Lungu, Edgar Arnold; Biesma, Regien; Chirwa, Maureen; Darker, Catherine

2016-08-19

Access to child health services is an important determinant of child health. Whereas, child health indicators are generally better in urban than rural areas, some population groups in urban areas, such as children residing in urban slums do not enjoy this urban health advantage. In the context of increasing urbanisation and urban poverty manifesting with proliferation of urban slums, the health of under-five children in slum areas remains a public health imperative in Malawi. This paper explores healthcare-seeking practices for common childhood illnesses focusing on use of biomedical health services and perceived barriers to accessing under-five child health services in urban slums of Lilongwe, Malawi's capital city. Qualitative data from 8 focus group discussions with caregivers and 11 in-depth interviews with key informants conducted from September 2012 to April 2013 were analysed using conventional content analysis. Whereas, caregivers sought care from biomedical health providers, late care-seeking also emerged as a major theme and phenomenon. Home management was actively undertaken for childhood illnesses. Various health system barriers: lack of medicines and supplies; long waiting times; late facility opening times; negative attitude of health workers; suboptimal examination of the sick child; long distance to health facility; and cost of healthcare were cited in this qualitative inquiry as critical health system factors affecting healthcare-seeking for child health services. Interventions to strengthen the health system's responsiveness to expectations are essential to promote utilisation of child health services among urban slum populations, and ultimately improve child health and survival.

Global Urban Mapping and Modeling for Sustainable Urban Development

NASA Astrophysics Data System (ADS)

Zhou, Y.; Li, X.; Asrar, G.; Yu, S.; Smith, S.; Eom, J.; Imhoff, M. L.

2016-12-01

In the past several decades, the world has experienced fast urbanization, and this trend is expected to continue for decades to come. Urbanization, one of the major land cover and land use changes (LCLUC), is becoming increasingly important in global environmental changes, such as urban heat island (UHI) growth and vegetation phenology change. Better scientific insights and effective decision-making unarguably require reliable science-based information on spatiotemporal changes in urban extent and their environmental impacts. In this study, we developed a globally consistent 20-year urban map series to evaluate the time-reactive nature of global urbanization from the nighttime lights remote sensing data, and projected future urban expansion in the 21st century by employing an integrated modeling framework (Zhou et al. 2014, Zhou et al. 2015). We then evaluated the impacts of urbanization on building energy use and vegetation phenology that affect both ecosystem services and human health. We extended the modeling capability of building energy use in the Global Change Assessment Model (GCAM) with consideration of UHI effects by coupling the remote sensing based urbanization modeling and explored the impact of UHI on building energy use. We also investigated the impact of urbanization on vegetation phenology by using an improved phenology detection algorithm. The derived spatiotemporal information on historical and potential future urbanization and its implications in building energy use and vegetation phenology will be of great value in sustainable urban design and development for building energy use and human health (e.g., pollen allergy), especially when considered together with other factors such as climate variability and change. Zhou, Y., S. J. Smith, C. D. Elvidge, K. Zhao, A. Thomson & M. Imhoff (2014) A cluster-based method to map urban area from DMSP/OLS nightlights. Remote Sensing of Environment, 147, 173-185. Zhou, Y., S. J. Smith, K. Zhao, M. Imhoff, A. Thomson, B. Bond-Lamberty, G. R. Asrar, X. Zhang, C. He & C. D. Elvidge (2015) A global map of urban extent from nightlights. Environmental Research Letters, 10, 054011.

Housing Satisfaction Related to Health and Importance of Services in Urban Slums: Evidence from Dhaka, Bangladesh

ERIC Educational Resources Information Center

Zanuzdana, Arina; Khan, Mobarak; Kraemer, Alexander

2013-01-01

Quality of housing plays one of the key roles in a public health research, since inadequate housing may have direct or indirect negative impact on health. Higher satisfaction with housing was shown to be associated with higher income, higher age, a smaller family, higher education, being female and being an owner of a dwelling. The aim of our…

Health inequalities among urban children in India: a comparative assessment of Empowered Action Group (EAG) and South Indian states.

PubMed

Arokiasamy, P; Jain, Kshipra; Goli, Srinivas; Pradhan, Jalandhar

2013-03-01

As India rapidly urbanizes, within urban areas socioeconomic disparities are rising and health inequality among urban children is an emerging challenge. This paper assesses the relative contribution of socioeconomic factors to child health inequalities between the less developed Empowered Action Group (EAG) states and more developed South Indian states in urban India using data from the 2005-06 National Family Health Survey. Focusing on urban health from varying regional and developmental contexts, socioeconomic inequalities in child health are examined first using Concentration Indices (CIs) and then the contributions of socioeconomic factors to the CIs of health variables are derived. The results reveal, in order of importance, pronounced contributions of household economic status, parent's illiteracy and caste to urban child health inequalities in the South Indian states. In contrast, parent's illiteracy, poor economic status, being Muslim and child birth order 3 or more are major contributors to health inequalities among urban children in the EAG states. The results suggest the need to adopt different health policy interventions in accordance with the pattern of varying contributions of socioeconomic factors to child health inequalities between the more developed South Indian states and less developed EAG states.

Building a partnership to evaluate school-linked health services: the Cincinnati School Health Demonstration Project.

PubMed

Rose, Barbara L; Mansour, Mona; Kohake, Kelli

2005-12-01

The Cincinnati School Health Demonstration Project was a 3-year collaboration that evaluated school-linked health services in 6 urban elementary (kindergarten to eighth grade) schools. Partners from the Cincinnati Health Department, Cincinnati Public Schools, Cincinnati Children's Hospital Medical Center, and The Health Foundation of Greater Cincinnati wanted to determine if levels of school-linked care made a difference in student quality of life, school connectedness, attendance, emergency department use, and volume of referrals to health care specialists. School nurses, principals and school staff, parents and students, upper-level managers, and health service researchers worked together over a 2.5-year period to learn about and use new technology to collect information on student health, well-being, and outcome measures. Varying levels of school health care intervention models were instituted and evaluated. A standard model of care was compared with 2 models of enhanced care and service. The information collected from students, parents, nurses, and the school system provided a rich database on the health of urban children. School facilities, staffing, and computer technology, relationship building among stakeholders, extensive communication, and high student mobility were factors that influenced success and findings of the project. Funding for district-wide computerization and addition of school health staff was not secured by the end of the demonstration project; however, relationships among the partners endured and paved the way for future collaborations designed to better serve urban school children in Cincinnati.

The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments.

PubMed

Leider, Jonathon P; Castrucci, Brian C; Harris, Jenine K; Hearne, Shelley

2015-08-06

The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments

PubMed Central

Leider, Jonathon P.; Castrucci, Brian C.; Harris, Jenine K.; Hearne, Shelley

2015-01-01

Background: The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff. PMID:26258784

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.

Perceived Health Benefits and Willingness to Pay for Parks by Park Users: Quantitative and Qualitative Research

PubMed Central

Henderson-Wilson, Claire; Sia, Kah-Ling; Veitch, Jenny; Staiger, Petra K; Davidson, Penny; Nicholls, Peter

2017-01-01

Whilst a growing body of evidence demonstrates people derive a range of health and wellbeing benefits from visiting parks, only a limited number of attempts have been made to provide a complementary economic assessment of parks. The aim of this exploratory study was to directly estimate the perceived health and wellbeing benefits attained from parks and the economic value assigned to parks by park users in Victoria, Australia. The research employed a mixed methods approach (survey and interviews) to collect primary data from a selection of 140 park users: 100 from two metropolitan parks in Melbourne and 40 from a park on the urban fringe of Melbourne, Victoria. Our findings suggest that park users derive a range of perceived physical, mental/spiritual, and social health benefits, but park use was predominantly associated with physical health benefits. Overall, our exploratory study findings suggest that park users are willing to pay for parks, as they highly value them as places for exercising, socialising, and relaxing. Importantly, most people would miss parks if they did not exist. The findings aim to provide park managers, public health advocates, and urban policy makers with evidence about the perceived health and wellbeing benefits of park usage and the economic value park visitors place on parks. PMID:28505123

Perceived Health Benefits and Willingness to Pay for Parks by Park Users: Quantitative and Qualitative Research.

PubMed

Henderson-Wilson, Claire; Sia, Kah-Ling; Veitch, Jenny; Staiger, Petra K; Davidson, Penny; Nicholls, Peter

2017-05-15

Whilst a growing body of evidence demonstrates people derive a range of health and wellbeing benefits from visiting parks, only a limited number of attempts have been made to provide a complementary economic assessment of parks. The aim of this exploratory study was to directly estimate the perceived health and wellbeing benefits attained from parks and the economic value assigned to parks by park users in Victoria, Australia. The research employed a mixed methods approach (survey and interviews) to collect primary data from a selection of 140 park users: 100 from two metropolitan parks in Melbourne and 40 from a park on the urban fringe of Melbourne, Victoria. Our findings suggest that park users derive a range of perceived physical, mental/spiritual, and social health benefits, but park use was predominantly associated with physical health benefits. Overall, our exploratory study findings suggest that park users are willing to pay for parks, as they highly value them as places for exercising, socialising, and relaxing. Importantly, most people would miss parks if they did not exist. The findings aim to provide park managers, public health advocates, and urban policy makers with evidence about the perceived health and wellbeing benefits of park usage and the economic value park visitors place on parks.

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.

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.

Rural and urban breastfeeding initiation trends in low-income women in North Carolina from 2003 to 2007.

PubMed

Lynch, Suzanne; Bethel, Jeffrey; Chowdhury, Najmul; Moore, Justin B

2012-05-01

Breastfeeding has extensive health benefits for both infants and mothers. Despite these benefits, a significant number of women, disproportionately low-income women, do not initiate breastfeeding. Previous research has also demonstrated that breastfeeding prevalence varies by urbanicity level. The objective was to examine race/ethnicity and urbanicity trends in breastfeeding initiation among low-income women in North Carolina from 2003 to 2007. Breastfeeding initiation data from the North Carolina Pregnancy Nutrition Surveillance System were utilized, with responses from 240,054 women over the 5-year period. Overall, 65.4% of women in mixed-urban counties and 62.1% of women in urban counties initiated breastfeeding compared to only 49.8% of women in rural counties. The disparity between rural and urban counties widened over time, with urban and mixed-urban counties making significantly greater gains in breastfeeding initiation than rural counties. Hispanic and non-Hispanic white women had 6.17 (95% confidence interval [CI], 5.99-6.36) and 1.4 (95% CI, 1.46-1.53) times the odds of initiating breastfeeding as non-Hispanic blacks, respectively. Finally, stratified multivariate regression models identified that the association between race/ethnicity and breastfeeding varied by urbanicity level. The current study provides a clearer picture of rural and urban breastfeeding trends within North Carolina and has implications for states with similar racial/ethnic and urbanicity levels. The research determined that women in rural areas, particularly non-Hispanic blacks, are less likely to initiate breastfeeding. Increased emphasis should be placed on developing breastfeeding interventions for rural communities, particularly targeting the non-Hispanic black population.

Effect of medicare payment on rural health care systems.

PubMed

McBride, Timothy D; Mueller, Keith J

2002-01-01

Medicare payments constitute a significant share of patient-generated revenues for rural providers, more so than for urban providers. Therefore, Medicare payment policies influence the behavior of rural providers and determine their financial viability. Health services researchers need to contribute to the understanding of the implications of changes in fee-for-service payment policy, prospects for change because of the payment to Medicare+Choice risk plans, and implications for rural providers inherent in any restructuring of the Medicare program. This article outlines the basic policy choices, implications for rural providers and Medicare beneficiaries, impacts of existing research, and suggestions for further research. Topics for further research include implications of the Critical Access Hospital program, understanding how changes in payment to rural hospitals affect patient care, developing improved formulas for paying rural hospitals, determining the payment-to-cost ratio for physicians, measuring the impact of changes in the payment methodology used to pay for services delivered by rural health clinics and federally qualified health centers, accounting for the reasons for differences in historical Medicare expenditures across rural counties and between rural and urban counties, explicating all reasons for Medicare+Choice plans withdrawing from some rural areas and entering others, measuring the rural impact of proposals to add a prescription drug benefit to the Medicare program, and measuring the impact of Medicare payment policies on rural economies.

A new role for Women Health Volunteers in urban Islamic Republic of Iran.

PubMed

Behdjat, H; Rifkin, S B; Tarin, E; Sheikh, M R

2009-01-01

An action research project was carried out by a team from the National Public Health Management Centre in Tabriz, Iran to test the following hypothesis: Health Volunteers are more able to support health improvements by focusing on community participation and empowerment through facilitating communities to define and solve their own problems than by only providing information on health problems. Training on participatory approaches was given to Women Health Volunteers (WHV) in a pilot area. The results gave evidence that local people could identify and act upon their own health needs and request more information from professionals to improve their own health. Further research is needed however to assess how the pilot can be scaled up and how initial enthusiasm can be sustained.

Development of an Urban Health Impact Assessment methodology: indicating the health equity impacts of urban policies.

PubMed

Pennington, Andy; Dreaves, Hilary; Scott-Samuel, Alex; Haigh, Fiona; Harrison, Annie; Verma, Arpana; Pope, Daniel

2017-05-01

An overarching recommendation of the global Commission on Social Determinants of Health was to measure and understand health inequalities and assess the impact of action. In a rapidly urbanising world, now is the time for Urban HIA. This article describes the development of robust and easy-to-use HIA tools to identify and address health inequalities from new urban policies. Rapid reviews and consultation with experts identified existing HIA screening tools and methodologies which were then analyzed against predefined selection criteria. A draft Urban HIA Screening Tool (UrHIST) and Urban HIA methodology (UrHIA) were synthesised. The draft tools were tested and refined using a modified Delphi approach that included input from urban and public health experts, practitioners and policy makers. The outputs were two easy-to-use stand-alone urban HIA tools. The reviews and consultations identified an underpinning conceptual framework. The screening tool is used to determine whether a full HIA is required, or for a brief assessment. Urban health indicators are a readily available and efficient means of identifying variations in the health of populations potentially affected by policies. Indicators are, however, currently underutilised in HIA practice. This may limit the identification of health inequalities by HIA and production of recommendations. The new tools utilise health indicator data more fully. UrHIA also incorporates a hierarchy of evidence for use during impact analysis. The new urban HIA tools have the potential to enhance the rigour of HIAs and improve the identification and amelioration of health inequalities generated by urban policies. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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.

Resources for nurturing childcare practices in urban and rural settings: Findings from the Colombia 2010 Demographic and Health Survey.

PubMed

Urke, H B; Mittelmark, M B; Amugsi, D A; Matanda, D J

2018-05-01

The health and development potential of young children is dependent on nurturing care (NC) provided by primary caregivers. NC encompasses attention to nutrition; symptom management; early learning, attachment, and socialization; and security and safety. Despite the importance of NC to child health and development, the measurement and study of NC are neglected. This has become a point of major concern in the public health field in low- and middle-income countries (LMICs) such as Colombia where many families are hard pressed for childcare resources. The aims of this study were therefore to (a) create age-specific NC summary indexes (0-5, 6-11, and 12-23 months) suitable for research in LMICs and (2) examine the relationship of NC to maternal resources. 2010 Colombia Demographic and Health Survey data were obtained from mothers and their children ages 0-5 months (n = 1,357); 6-11 months (n = 1,623); and 12-23 months (n = 3,006). Age-specific NC indexes were created including information on child feeding, immunization, hygiene, response to illness symptoms, and psychosocial care. Independent variables included mother's education level and household assets, and enrolment in a government child development programme. Regression analyses with NC as the outcome variable were conducted with urban and rural subsamples in the 3 age groups. Among rural children, NC was significantly higher with greater household assets, maternal decision latitude, and development programme participation, with variation by child age. Among urban children, higher maternal education and white-collar occupation also predicted higher NC, with some variation by age. It is feasible to measure age-specific NC in survey research, and NC is related to maternal resources. Age and urban-rural differences in how NC is related to social factors are observed. The findings support the importance of subgroup analysis in the study of NC in LMICs such as Colombia. © 2018 John Wiley & Sons Ltd.

Exploring perceptions of group antenatal Care in Urban India: results of a feasibility study.

PubMed

Jolivet, R Rima; Uttekar, Bella Vasant; O'Connor, Meaghan; Lakhwani, Kanchan; Sharma, Jigyasa; Wegner, Mary Nell

2018-04-03

Making high-quality health care available to all women during pregnancy is a critical strategy for improving perinatal outcomes for mothers and babies everywhere. Research from high-income countries suggests that antenatal care delivered in a group may be an effective way to improve the provision, experiences, and outcomes of care for pregnant women and newborns. A number of researchers and programmers are adapting group antenatal care (ANC) models for use in low- and middle-income countries (LMIC), but the evidence base from these settings is limited and no studies to date have assessed the feasibility and acceptability of group ANC in India. We adapted a "generic" model of group antenatal care developed through a systematic scoping review of the existing evidence on group ANC in LMICs for use in an urban setting in India, after looking at local, national and global guidelines to tailor the model content. We demonstrated one session of the model to physicians, auxiliary nurse midwives, administrators, pregnant women, and support persons from three different types of health facilities in Vadodara, India and used qualitative methods to gather and analyze feedback from participants on the perceived feasibility and acceptability of the model. Providers and recipients of care expressed support and enthusiasm for the model and offered specific feedback on its components: physical assessment, active learning, and social support. In general, after witnessing a demonstration of the model, both groups of participants-providers and beneficiaries-saw group ANC as a vehicle for delivering more comprehensive ANC services, improving experiences of care, empowering women to become more active partners and participants in their care, and potentially addressing some current health system challenges. This study suggests that introducing group ANC would be feasible and acceptable to stakeholders from various care delivery settings, including an urban primary health clinic, a community-based mother and child health center, and a private hospital, in urban India.

The professional role of massage therapists in patient care in Canadian urban hospitals--a mixed methods study.

PubMed

Kania-Richmond, Ania; Reece, Barb Findlay; Suter, Esther; Verhoef, Marja J

2015-02-07

Massage therapy (MT) is becoming established as a recognized health care profession in Canada. It has been integrated as a core service in settings such as health spas, private integrative health centers, and there is indication that MT is starting to be integrated into hospitals. Research in the area of hospital-based MT has primarily focused on the efficacy, effectiveness, and increasingly, the safety of MT. However, little is known about the professional role of massage therapists in the hospital setting. The purpose of this study was to conduct an in-depth exploration and description of massage therapists' professional role in patient care in the context of Canadian urban hospitals. A sequential mixed methods study design was used. For the quantitative phase, a survey was sent to urban hospitals where MT services were organized by hospitals and provided by licensed massage therapists to patients to a) provide a contextual description of the hospitals and b) identify a sampling frame for the qualitative phase. The subsequent qualitative phase entailed semi structured interviews with a purposively diverse sample of participants massage therapists from the surveyed sites to explore their role perceptions. The quantitative and qualitative approaches were integrated during data collection and analysis. Of the hospitals that responded, sixteen urban hospitals across Canada (5%) provided MT to patients by licensed therapists. The majority of hospitals were located in Ontario and ranged from specialized small community hospitals to large multi-site hospitals. Based on interviews with 25 participants, six components of the massage therapists' professional role emerged: health care provider, team member, program support, educator, promoter of the profession, and researcher. While hospital-based MT in Canada is not a new phenomenon, MT is not yet an established health care profession in such settings. However, there is significant potential for the inclusion of the massage therapists' role in Canadian hospitals that should be evidence based for effective implementation.

Maternal Cultural Participation and Child Health Status in a Middle Eastern Context: Evidence from the Urban Health Study

PubMed Central

Khawaja, Marwan; Barazi, Rana; Linos, Natalie

2006-01-01

Background The negative effect of poverty on child health has been well established. However, rapid urbanization in developing countries prompts new research questions relating to socio-cultural practices and other related variables in these settings. Objective To examine the association between maternal cultural participation and child health status in impoverished neighbourhoods of Beirut, Lebanon. Methods A cross-sectional survey of 1,241 mothers with children under 5 years was conducted from randomly selected households in three impoverished neighbourhoods of diverse ethnic and religious make-up. The outcome variable was child health status (good/bad) as assessed by the mother. Maternal variables, including cultural participation, education, demographic, and environmental/structural factors were studied. Descriptive statistics and bivariate associations were provided using Pearson’s χ2 tests. Unadjusted and adjusted odds ratios were then obtained from binary logistic regression models. Results Two indicators of maternal cultural participation, namely watching entertaining television and attending movies/art exhibitions, were found to be significantly associated to child health status after controlling for other risk factors. The quality of water, the quality of local health services, and maternal education were also significantly associated with child health status. Household income, child gender, and household dampness had no significant association with child health status in this context. Conclusion Maternal cultural participation was a significant predictor of child health status in impoverished urban communities. Improving child health through culturally focused interventions for mothers, especially in deprived areas, may be great. PMID:17291314

Maternal cultural participation and child health status in a Middle Eastern context: evidence from an urban health study.

PubMed

Khawaja, M; Barazi, R; Linos, N

2007-03-01

The negative effect of poverty on child health has been well established. However, rapid urbanization in developing countries prompts new research questions relating to socio-cultural practices and other related variables in these settings. To examine the association between maternal cultural participation and child health status in impoverished neighbourhoods of Beirut, Lebanon. A cross-sectional survey of 1241 mothers with children aged less than 5 years was conducted from randomly selected households in three impoverished neighbourhoods of diverse ethnic and religious make-up. The outcome variable was child health status (good/bad) as assessed by the mother. Maternal variables, including cultural participation, education, demographic and environmental/structural factors, were studied. Descriptive statistics and bivariate associations were provided using Pearson's chi-square tests. Unadjusted and adjusted odds ratios were then obtained from binary logistic regression models. Two indicators of maternal cultural participation, namely watching entertaining television and attending movies/art exhibitions, were found to be significantly associated with child health status after controlling for other risk factors. The quality of water, the quality of local health services and maternal education were also significantly associated with child health status. Household income, child gender and household dampness had no significant association with child health status in this context. Maternal cultural participation was a significant predictor of child health status in impoverished urban communities. Improving child health through culturally focused interventions for mothers, especially in deprived areas, may be greatly important.

Physiological and psychological responses of young males during spring-time walks in urban parks.

PubMed

Song, Chorong; Ikei, Harumi; Igarashi, Miho; Miwa, Masayuki; Takagaki, Michiko; Miyazaki, Yoshifumi

2014-05-01

It is widely believed that contact with the natural environment can improve physical and mental health. Urban green spaces may provide city residents with these benefits; however, there is a lack of empirical field research on the health benefits of urban parks. This field experiment was performed in May. Seventeen males aged 21.2 ± 1.7 years (mean ± standard deviation) were instructed to walk predetermined 15-minute courses in an urban park and a nearby city area (control). Heart rate and heart rate variability (HRV) were measured to assess physiological responses. The semantic differential (SD) method, Profile of Mood States (POMS), and State-Trait Anxiety Inventory (STAI) were used to measure psychological responses. Heart rate was significantly lower while walking in the urban park than while walking in the city street. Furthermore, the urban park walk led to higher parasympathetic nervous activity and lower sympathetic nervous activity compared with the walk through the city street. Subjective evaluations were generally in accordance with physiological reactions, and significantly higher scores were observed for the 'comfortable', 'natural', and 'relaxed' parameters following the urban park walk. After the urban park walk, the score for the 'vigor' subscale of the POMS was significantly higher, whereas that for negative feelings such as 'tension-anxiety' and 'fatigue' was significantly lower. The score for the anxiety dimension of the STAI was also significantly lower after the urban park walk. Physiological and psychological results from this field experiment provide evidence for the physiological and psychological benefits of urban green spaces. A brief spring-time walk in an urban park shifted sympathetic/parasympathetic balance and improved mood state.

The Impact of Community Design and Land-Use Choices on Public Health: A Scientific Research Agenda

PubMed Central

Dannenberg, Andrew L.; Jackson, Richard J.; Frumkin, Howard; Schieber, Richard A.; Pratt, Michael; Kochtitzky, Chris; Tilson, Hugh H.

2003-01-01

The design of a community’s built environment influences the physical and mental health of its residents. Because few studies have investigated this relationship, the Centers for Disease Control and Prevention hosted a workshop in May 2002 to help develop a scientific research agenda on these issues. Workshop participants’ areas of expertise included physical activity, injury prevention, air pollution, water quality, urban planning, transportation, architecture, epidemiology, land use, mental health, social capital, housing, and social marketing. This report describes the 37 questions in the resulting research agenda. The next steps are to define priorities and obtain resources. The proposed research will help identify the best practices for designing new communities and revitalizing old ones in ways that promote physical and mental health. PMID:12948970

Exploring ecological, emotional and social levers of self-rated health for urban gardeners and non-gardeners: A path analysis.

PubMed

Litt, J S; Schmiege, S J; Hale, J W; Buchenau, M; Sancar, F

2015-11-01

The social, emotional, and mental health benefits associated with gardening have been well documented. However, the processes underlying the relationship between garden participation and improvements in health status have not been sufficiently studied. Using population-based survey data (n = 469 urban residents), objective street environment data, and area-level measures, this research used a path analytic framework to examine several theoretically based constructs as mediators between gardening history and self-reported health. The results showed that garden participation influenced health status indirectly through social involvement with one's community, perceived aesthetic appeal of the neighborhood, and perceived collective efficacy. Gardeners, compared to non-gardeners, reported higher ratings of neighborhood aesthetics and more involvement in social activities, whereas aesthetics and involvement were associated with higher ratings of collective efficacy and neighborhood attachment. Collective efficacy, but not neighborhood attachment, predicted self-rated health. Gardening also directly influenced improved fruit and vegetable intake. The physical and social qualities of garden participation may therefore stimulate a range of interpersonal and social responses that are supportive of positive ratings of health. This research suggests that community planners and health professionals should aim to strengthen the social and aesthetic relationships while designing environments and policies as a way to ignite intermediate processes that may lead to improved health status. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploring ecological, emotional and social levers of self-rated health for urban gardeners and non-gardeners: A path analysis

PubMed Central

Schmiege, S; Hale, JW; Buchenau, M.; Sancar, F.

2015-01-01

Rationale The social, emotional, and mental health benefits associated with gardening have been well documented. However, the processes underlying the relationship between garden participation and improvements in health status have not been sufficiently studied. Methods Using population-based survey data (n = 469 urban residents), objective street environment data, and area-level measures, this research used a path analytic framework to examine several theoretically based constructs as mediators between gardening history and self-reported health. Results The results showed that garden participation influenced health status indirectly through social involvement with one’s community, perceived aesthetic appeal of the neighborhood, and perceived collective efficacy. Gardeners, compared to non-gardeners, reported higher ratings of neighborhood aesthetics and more involvement in social activities, whereas aesthetics and involvement were associated with higher ratings of collective efficacy and neighborhood attachment. Collective efficacy, but not neighborhood attachment, predicted self-rated health. Gardening also directly influenced improved fruit and vegetable intake. The physical and social qualities of garden participation may therefore stimulate a range of interpersonal and social responses that are supportive of positive ratings of health. Conclusion This research suggests that community planners and health professionals should aim to strengthen the social and aesthetic relationships while designing environments and policies as a way to ignite intermediate processes that may lead to improved health status. PMID:26372933

Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls.

PubMed

Mendenhall, Emily; Yarris, Kristin; Kohrt, Brandon A

2016-12-01

In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars' ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy.

Utilization of Standardized Mental Health Assessments in Anthropological Research: Possibilities and Pitfalls

PubMed Central

Mendenhall, Emily; Yarris, Kristin; Kohrt, Brandon A.

2017-01-01

In the past decade anthropologists working the boundary of culture, medicine, and psychiatry have drawn from ethnographic and epidemiological methods to interdigitate data and provide more depth in understanding critical health problems. But rarely do these studies incorporate psychiatric inventories with ethnographic analysis. This article shows how triangulation of research methods strengthens scholars’ ability (1) to draw conclusions from smaller data sets and facilitate comparisons of what suffering means across contexts; (2) to unpack the complexities of ethnographic and narrative data by way of interdigitating narratives with standardized evaluations of psychological distress; and (3) to enhance the translatability of narrative data to interventionists and to make anthropological research more accessible to policymakers. The crux of this argument is based on two discrete case studies, one community sample of Nicaraguan grandmothers in urban Nicaragua, and another clinic-based study of Mexican immigrant women in urban United States, which represent different populations, methodologies, and instruments. Yet, both authors critically examine narrative data and then use the Center for Epidemiologic Studies Depression Scale to further unpack meaning of psychological suffering by analyzing symptomatology. Such integrative methodologies illustrate how incorporating results from standardized mental health assessments can corroborate meaning-making in anthropology while advancing anthropological contributions to mental health treatment and policy. PMID:27553610

Policy, Research and Residents' Perspectives on Built Environments Implicated in Heart Disease: A Concept Mapping Approach.

PubMed

Stankov, Ivana; Howard, Natasha J; Daniel, Mark; Cargo, Margaret

2017-02-09

An underrepresentation of stakeholder perspectives within urban health research arguably limits our understanding of what is a multi-dimensional and complex relationship between the built environment and health. By engaging a wide range of stakeholders using a participatory concept mapping approach, this study aimed to achieve a more holistic and nuanced understanding of the built environments shaping disease risk, specifically cardiometabolic risk (CMR). Moreover, this study aimed to ascertain the importance and changeability of identified environments through government action. Through the concept mapping process, community members, researchers, government and non-government stakeholders collectively identified eleven clusters encompassing 102 built environmental domains related to CMR, a number of which are underrepresented within the literature. Among the identified built environments, open space, public transportation and pedestrian environments were highlighted as key targets for policy intervention. Whilst there was substantive convergence in stakeholder groups' perspectives concerning the built environment and CMR, there were disparities in the level of importance government stakeholders and community members respectively assigned to pedestrian environments and street connectivity. These findings support the role of participatory methods in strengthening how urban health issues are understood and in affording novel insights into points of action for public health and policy intervention.

Collecting standardized urban health indicator data at an individual level for school-aged children living in urban areas: methods from EURO-URHIS 2.

PubMed

Pope, D; Katreniak, Z; Guha, J; Puzzolo, E; Higgerson, J; Steels, S; Woode-Owusu, M; Bruce, N; Birt, Christopher A; Ameijden, E van; Verma, A

2017-05-01

Measuring health and its determinants in urban populations is essential to effectively develop public health policies maximizing health gain within this context. Adolescents are important in this regard given the origins of leading causes of morbidity and mortality develop pre-adulthood. Comprehensive, accurate and comparable information on adolescent urban health indicators from heterogeneous urban contexts is an important challenge. EURO-URHIS 2 aimed to develop standardized tools and methodologies collecting data from adolescents across heterogenous European urban contexts. Questionnaires were developed including (i) comprehensive assessment of urban health indicators from 7 pre-defined domains, (ii) use of previously validated questions from a literature review and other European surveys, (iii) translation/back-translation into European languages and (iv) piloting. Urban area-specific data collection methodologies were established through literature review, consultation and piloting. School-based surveys of 14-16-year olds (400-800 per urban area) were conducted in 13 European countries (33 urban areas). Participation rates were high (80-100%) for students from schools taking part in the surveys from all urban areas, and data quality was generally good (low rates of missing/spoiled data). Overall, 13 850 questionnaires were collected, coded and entered for EURO-URHIS 2. Dissemination included production of urban area health profiles (allowing benchmarking for a number of important public health indicators in young people) and use of visualization tools as part of the EURO-URHIS 2 project. EURO-URHIS 2 has developed standardized survey tools and methodologies for assessing key measures of health and its determinants in adolescents from heterogenous urban contexts and demonstrated the utility of this data to public health practitioners and policy makers. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Violence in Rural, Suburban, and Urban Schools in Pennsylvania.

PubMed

Flynn, Kalen; McDonald, Catherine C; D'Alonzo, Bernadette A; Tam, Vicky; Wiebe, Douglas J

2018-01-01

School violence is a public health issue with direct and collateral consequences that has academic and social impacts for youth. School violence is often considered a uniquely urban problem, yet more research is needed to understand how violence in rural and suburban schools may be similar or different from urban counterparts. Using school violence data from a state with urban, suburban, and rural counties, we explored the landscape of school violence in Pennsylvania (PA) through mapping, descriptive statistics, and factor analysis. Results show school violence is not solely an urban problem. Schools in all county types and across grade levels deal with violence to varying degrees, and the majority of schools across county types experience low levels of violence. Types of violence experienced by PA schools loaded onto three factors, suggesting that targeted interventions may be better suited to addressing school violence.

Prevalence of temporomandibular disorders: samples taken from attendees of medical health-care centers in the Islamic Republic of Iran.

PubMed

Balke, Zibandeh; Rammelsberg, Peter; Leckel, Michael; Schmitter, Marc

2010-01-01

To determine the prevalence of facial pain and temporomandibular disorders (TMD) in people located in urban and rural areas in a newly industrialized country (Iran). Two-hundred twenty-three subjects between 18 and 65 years of age (mean: 32.07; SD: 10.83) were randomly selected from an urban area and a rural area. One-hundred nineteen subjects from Mashhad (major city) and 104 subjects from Zoshk (village) were voluntarily recruited from medical health-care centers. Subjects who consulted the health-care center for dental, ear, nose, or throat issues were excluded. The monitoring of public health attendance of all citizens at designated health-care centers is compulsory by local law. All subjects were examined in accordance with the Research Diagnostic Criteria for TMD (RDC/TMD). Facial pain was assessed by using a questionnaire; the prevalence of myofascial pain, disc displacement, and degenerative disorders was determined by clinical examination. Nonparametric tests were used to assess group differences (ie, between village and city). Subjects in urban areas suffered less from facial pain (20.2% versus 46.2%; P < .01 [Mann-Whitney U test]) than subjects in rural areas. The frequency of TMD, disc displacement, and degenerative disorders was greater in the rural area. The symptoms under investigation were significantly more widespread in rural than in urban areas. With regard to TMD per se, the place of residence appears to be unimportant. However, the rural population was significantly affected by facial pain.

Can Aerosol Offset Urban Heat Island Effect?

NASA Astrophysics Data System (ADS)

Jin, M. S.; Shepherd, J. M.

2009-12-01

The Urban Heat Island effect (UHI) refers to urban skin or air temperature exceeding the temperatures in surrounding non-urban regions. In a warming climate, the UHI may intensify extreme heat waves and consequently cause significant health and energy problems. Aerosols reduce surface insolation via the direct effect, namely, scattering and absorbing sunlight in the atmosphere. Combining the National Aeronautics and Space Administration (NASA) AERONET (AErosol RObotic NETwork) observations over large cities together with Weather Research and Forecasting Model (WRF) simulations, we find that the aerosol direct reduction of surface insolation range from 40-100 Wm-2, depending on seasonality and aerosol loads. As a result, surface skin temperature can be reduced by 1-2C while 2-m surface air temperature by 0.5-1C. This study suggests that the aerosol direct effect is a competing mechanism for the urban heat island effect (UHI). More importantly, both aerosol and urban land cover effects must be adequately represented in meteorological and climate modeling systems in order to properly characterize urban surface energy budgets and UHI.

75 FR 65357 - Request for Public Comment: 30-Day Proposed Information Collection: Office of Urban Indian Health...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-22

... Collection: Title: Office of Urban Indian Health Programs (OUIHP) Uniform Data System (UDS). Type of... Respondents: Title V urban Indian health programs. The table below provides: Types of data collection... Proposed Information Collection: Office of Urban Indian Health Programs; Uniform Data System AGENCY: Indian...

Malnutrition among women in sub-Saharan Africa: rural-urban disparity.

PubMed

Uthman, O A; Aremu, O

2008-01-01

Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity among women. To provide a reliable source of information for policy-makers, the current study used nationally representative data from 26 countries in sub-Saharan Africa to update knowledge about the prevalence malnutrition and its rural-urban disparities among women. The data sources were the demographic and health surveys of 26 countries conducted between 1995 and 2006. The methods included meta-analysis, meta-regression, sub-group and sensitivity. Overall, rural women were 68% more likely to be malnourished compared with their urban counterparts. In the meta-regression analysis, sub-region, sample size, and the year the study was conducted explained the observed heterogeneity. This meta-analysis provided usable data for women in sub-Saharan Africa. The magnitude of rural-urban malnutrition disparity revealed provides a baseline that will be of assistance to clinicians, researchers, and policy-makers in the detection, prevention and treatment of malnutrition among rural women.

Using Participatory Action Research to Increase Learning Transfer of Recovery-Based Principles

ERIC Educational Resources Information Center

Barish, Diane J.

2009-01-01

This study questions whether or not participatory action research is an effective and practical method for increasing learning transfer of recovery-based principles. The participants (N = 250) were ethnically and educationally diverse clinicians, in an urban state mental health institute. The Self-Assessment of Recovery-Based Behaviors survey ( n…

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.…

Mortality by skin color/race and urbanity of Brazilian cities.

PubMed

de Oliveira, Bruno Luciano Carneiro Alves; Luiz, Ronir Raggio

2017-08-01

The skin color/race and urbanity are structural determinants of health. The relationship between these variables produces structure of social stratification that defines inequalities in the experiences of life and death. Thus, this study describes the characteristics of the mortality indicators by skin color/race according level of urbanity and aggregation to the metropolitan region (MR) of 5565 cities in Brazil, controlling for gender and age. Descriptive study which included the calculation of measures relating to 1,050,546 deaths in the year survey of 2010 by skin color/race White, Black, and Brown according to both sexes, for five age groups and three levels of urbanity of cities in Brazil that were aggregated or not to the MR in the year of study. The risk of death was estimated by calculating premature mortality rate (PMR) at 65 years of age, per 100,000 and age adjusted. The structure of mortality by skin color/race Black and Brown reflects worse levels of health and excessive premature deaths, with worse situation for men. The Whites, especially women, tend to live longer and in better health than other racial groups. The age-adjusted PMR indicates distinct risk of death by skin color/race, this risk was higher in men than in women and in Blacks than in other racial groups of both sexes. There have been precarious levels of health in the urban space and the MR has intensified these inequalities. The research pointed out that the racial inequality in the mortality was characterized by interaction of race with other individual and contextual determinants of health. Those Blacks and Browns are the groups most vulnerable to the iniquities associated with occurrence of death, but these differences in the profile and the risk of death depend on the level of urbanity and aggregation MR of Brazilian cities in 2010.

Urban Malaria: Understanding its Epidemiology, Ecology, and Transmission Across Seven Diverse ICEMR Network Sites.

PubMed

Wilson, Mark L; Krogstad, Donald J; Arinaitwe, Emmanuel; Arevalo-Herrera, Myriam; Chery, Laura; Ferreira, Marcelo U; Ndiaye, Daouda; Mathanga, Don P; Eapen, Alex

2015-09-01

A major public health question is whether urbanization will transform malaria from a rural to an urban disease. However, differences about definitions of urban settings, urban malaria, and whether malaria control should differ between rural and urban areas complicate both the analysis of available data and the development of intervention strategies. This report examines the approach of the International Centers of Excellence for Malaria Research (ICEMR) to urban malaria in Brazil, Colombia, India (Chennai and Goa), Malawi, Senegal, and Uganda. Its major theme is the need to determine whether cases diagnosed in urban areas were imported from surrounding rural areas or resulted from transmission within the urban area. If infections are being acquired within urban areas, malaria control measures must be targeted within those urban areas to be effective. Conversely, if malaria cases are being imported from rural areas, control measures must be directed at vectors, breeding sites, and infected humans in those rural areas. Similar interventions must be directed differently if infections were acquired within urban areas. The hypothesis underlying the ICEMR approach to urban malaria is that optimal control of urban malaria depends on accurate epidemiologic and entomologic information about transmission. © The American Society of Tropical Medicine and Hygiene.

Trade-offs between commuting time and health-related activities.

PubMed

Christian, Thomas J

2012-10-01

To further understand documented associations between obesity and urban sprawl, this research describes individuals' trade-offs between health-related activities and commuting time. A cross-section of 24,861 working-age individuals employed full-time and residing in urban counties is constructed from the American Time Use Survey (2003-2010). Data are analyzed using seemingly unrelated regressions to quantify health-related activity decreases in response to additional time spent commuting. Outcomes are total daily minutes spent in physical activity at a moderate or greater intensity, preparing food, eating meals with family, and sleeping. Commuting time is measured as all travel time between home and work and vice versa. The mean commuting time is 62 min daily, the median is 55 min, and 10.1% of workers commute 120 min or more. Spending an additional 60 min daily commuting above average is associated with a 6% decrease in aggregate health-related activities and spending an additional 120 min is associated with a 12% decrease. The greatest percentage of commuting time comes from sleeping time reductions (28-35%). Additionally, larger proportions of commuting time are taken from physical activity and food preparation relative to the mean commuting length: of 60 min spent commuting, 16.1% is taken from physical activity and 4.1% is taken from food preparation; of 120 min commuting, 20.3% is taken from physical activity and 5.6% is taken from food preparation. The results indicate that longer commutes are associated with behavioral patterns which over time may contribute to obesity and other poor health outcomes. These findings will assist both urban planners and researchers wishing to understand time constraints' impacts on health.

Urban and rural variations in morbidity and mortality in Northern Ireland

PubMed Central

O'Reilly, Gareth; O' Reilly, Dermot; Rosato, Michael; Connolly, Sheelah

2007-01-01

Background From a public health perspective and for the appropriate allocation of resources it is important to understand the differences in health between areas. This paper examines the variations in morbidity and mortality between urban and rural areas. Methods This is a cohort study looking at morbidity levels of the population of Northern Ireland at the time of the 2001 census, and subsequent mortality over the following four years. Individual characteristics including demographic and socio-economic factors were as recorded on census forms. The urban-rural nature of residence was based on census areas (average population c1900) classified into eight settlement bands, ranging from cities to rural settlements with populations of less than 1000. Results The study shows that neither tenure nor car availability are unbiased measures of deprivation in the urban-rural context. There is no indication that social class is biased. There was an increasing gradient of poorer health from rural to urban areas, where mortality rates were about 22% (95% Confidence Intervals 19%–25%) higher than the most rural areas. Differences in death rates between rural and city areas were evident for most of the major causes of death but were greatest for respiratory disease and lung cancer. Conversely, death rates in the most rural areas were higher in children and adults aged less than 20. Conclusion Urban areas appear less healthy than the more rural areas and the association with respiratory disease and lung cancer suggests that pollution may be a factor. Rural areas however, have higher death rates amongst younger people, something which requires further research. There is also a need for additional indicators of deprivation that have equal meaning in urban and rural areas. PMID:17594471

Urbanization of black South African women may increase risk of low bone mass due to low vitamin D status, low calcium intake, and high bone turnover.

PubMed

Kruger, Marlena C; Kruger, Iolanthé M; Wentzel-Viljoen, Edelweiss; Kruger, Annamarie

2011-10-01

Globally, rural to urban migration is accompanied by changes in dietary patterns and lifestyle that have serious health implications, including development of low bone mass. We hypothesized that serum 25 (OH) vitamin D3 (25[OH]D3) levels will be lower, bone turnover higher, and nutrition inadequate in urban postmenopausal black women, increasing risk for low bone mass. We aimed to assess the prevalence of risk factors for low bone mass in 1261 black women from rural and urban areas in the North West Province of South Africa (Prospective Urban and Rural Epidemiology-South Africa project). Fasting blood samples were taken; and participants were interviewed to complete questionnaires on self-reported diseases, fractures, and dietary intakes. Bone health markers were assessed in a subgroup of 658 women older than 45 years. Specific lifestyle risk factors identified were inactivity, smoking, injectable progestin contraception use, and high alcohol consumption. Dietary risk factors identified were low calcium and high animal protein, phosphorous, and sodium intakes. The 25(OH)D3 and C-terminal telopeptide (CTX) levels were significantly higher in the rural vs the urban women older than 50 years. Parathyroid hormone (PTH) levels increased with age in both groups. The 25(OH)D levels were inversely correlated with CTX and PTH in rural women. In urban women, PTH and CTX were correlated while dietary calcium was inversely correlated with CTX and PTH with 25(OH)D3. The combination of low dietary calcium (<230 mg/d), marginally insufficient 25(OH)D3 status, and raised PTH may result in increased bone resorption. Further research is required to assess bone health and fracture risk in black African women. Copyright © 2011 Elsevier Inc. All rights reserved.

Large urban-rural disparity in the severity of two-week illness: updated results based on the first health service survey of Hunan Province, China.

PubMed

Tian, Danping; Sun, Li; Zhang, Lingling; Zhang, Lin; Zhang, Wei; Li, Li; Deng, Xin; Ning, Peishan; Cheng, Xunjie; Deng, Jing; Hu, Guoqing

2016-02-29

To examine urban-rural differences in the severity of non-fatal disease and injury using the latest household interview survey data of Hunan Province, China. Two-week illness data were from the first provincial health household interview survey of Hunan in 2013. The proportion of patients being bedridden, the average days of being bedridden and the average off-work days were calculated to measure the severity of two-week illness. Rao-Scott-adjusted chi-square test was performed to examine the significance of two-week illness severity differences from demographic variables. Multiple logistic regression and linear regression were used to control for sex, age and household income. The two-week illness prevalence was 22.8 % in Hunan province. Despite similar two-week ill prevalence rates between urban areas and rural areas (23.0 % vs. 22.8 %), rural residents had higher proportions of being bedridden and of being off work than urban residents after controlling for sex, age and household income, with adjusted odds ratios of 3.4 and 6.9, respectively. Similarly, the average days of being bedridden and of being off work in rural residents were 0.45 days and 1.61 days longer than in urban residents after controlling for demographic variables, respectively. The recent data shows that two-week illness in rural residents is more serious than urban residents in Hunan Province, China in spite of very similar two-week prevalence rates. The neglected urban-rural disparities in the severity of two-week illness deserve the attention of health policy-makers and researchers.

The relationship between new media exposure and fast food consumption among Chinese children and adolescents in school: a rural-urban comparison.

PubMed

Hansstein, Francesca Valeria; Hong, Yu; Di, Chen

2017-09-01

In recent decades, China has experienced an exponential growth in the number of internet users, especially among the youngest population, as well as a rapid proliferation of Western-type fast food restaurants. The health consequences of internet availability and fast food consumption among youth have been largely studied in Western countries, but few studies have focused on China. This paper has two goals. The first is to evaluate the differences in new media exposure and preferences for fast foods between rural and urban areas. The second goal is to test the association between new media exposure and fast food consumption. The targets of this analysis are Chinese children and adolescents aged 6-18 attending school at the time of the interview. Research hypotheses were tested using mean-groups comparisons for differences between rural urban sub-samples, and logistic regressions with odds ratios to estimate the relationship between media exposure and preferences towards fast foods. Cross-sectional data from the 2009 China Health and Nutrition Survey were employed. Watching online videos and playing computer games are behaviors associated with higher probabilities of eating at fast food restaurants in both rural and urban young residents, with higher odds in rural areas. Surfing the internet is associated with higher odds of being overweight in both rural and urban settings. Results also show that children living in rural areas spend significantly more time playing computer games, watching TV and videotapes, but less time doing homework than their urban peers. This paper suggests that monitoring the nutritional effects of new media exposure in China is of key importance in order to develop adequate health promotion policies, in both rural and urban areas.

Setting Goals for Urban Scale Climate Governance

NASA Astrophysics Data System (ADS)

Rosenthal, J. K.; Brunner, E.

2007-12-01

The impacts of climate change on temperate urban areas may include the increase in frequency and intensity of damaging extreme weather events, such as heat waves, hurricanes, heavy rainfall or drought, and coastal flooding and erosion, and potential adverse impacts on infrastructure, energy systems, and public health. Warmer average summertime temperatures are also associated with environmental and public health liabilities, such as decreased air quality and increased peak electrical demand. Simultaneously, a strong global trend towards urbanization of poverty exists, with increased challenges for local governments to protect and sustain the well-being of growing cities and populations currently stressed by poverty, health and economic inequities. In the context of these trends, research at the city scale has sought to understand the social and economic impacts of climate change and variability and to evaluate strategies in the built environment that might serve as adaptive and mitigative responses to climate change. We review the goals and outcomes of several municipal climate protection programs, generally categorized as approaches based on technological innovation (e.g., new materials); changes in behavior and public education (e.g., neighborhood watch programs and cooling centers); improvements in urban design (e.g., zoning for mixed land-use; the use of water, vegetation and plazas to reduce the urban heat island effect); and efforts to incentivize the use of non-fossil-fuel based energy sources. Urban initiatives in European and American cities are assessed within the context of the global collective efforts enacted by the Kyoto Protocol and United Nations Framework Convention on Climate Change. Our concern is to understand the active networked role of urban managers in climate policies and programs in relation to supranational objectives and non-state actors.

Natural calamities and 'the Big Migration': challenges to the Mongolian health system in 'the Age of the Market'.

PubMed

Lindskog, Benedikte V

2014-01-01

Beginning with the demise of the socialist state system in 1990, Mongolia embarked on a process of neoliberal economic reform, initiating what is known among the Mongols as 'the Age of the Market'. The socialist health system has been replaced by a series of reforms initiated and substantiated by foreign donor organisations. This paper critically examines Mongolia's health system and discusses the extent to which this 'system', despite its provision of universal, accessible and essential primary health care services, is unable to accommodate the health needs of poor urban in-migrants and nomadic herders in remote provinces. With a particular focus on recurrent natural winter disasters (dzud) and an escalating rural to urban migration, the paper argues that the issues of access to health services and health system strengthening must be understood in relation to factors external to the health system. Ethnographic research highlights that despite a growing economy, considerable external aid and an established primary health care model, weak rural politics, environmental challenges and economic constraints create escalating health vulnerability among the poorest in Mongolia.

The place of health and the health of place: dengue fever and urban governance in Putrajaya, Malaysia.

PubMed

Mulligan, K; Elliott, S J; Schuster-Wallace, C

2012-05-01

This case study investigates the connections among urban planning, governance and dengue fever in an emerging market context in the Global South. Key informant interviews were conducted with leading figures in public health, urban planning and governance in the planned city of Putrajaya, Malaysia. Drawing on theories of urban political ecology and ecosocial epidemiology, the qualitative study found the health of place - expressed as dengue-bearing mosquitoes and dengue fever in human bodies in the urban environment - was influenced by the place of health in a hierarchy of urban priorities. Copyright © 2012 Elsevier Ltd. All rights reserved.

PM10 modeling in the Oviedo urban area (Northern Spain) by using multivariate adaptive regression splines

NASA Astrophysics Data System (ADS)

Nieto, Paulino José García; Antón, Juan Carlos Álvarez; Vilán, José Antonio Vilán; García-Gonzalo, Esperanza

2014-10-01

The aim of this research work is to build a regression model of the particulate matter up to 10 micrometers in size (PM10) by using the multivariate adaptive regression splines (MARS) technique in the Oviedo urban area (Northern Spain) at local scale. This research work explores the use of a nonparametric regression algorithm known as multivariate adaptive regression splines (MARS) which has the ability to approximate the relationship between the inputs and outputs, and express the relationship mathematically. In this sense, hazardous air pollutants or toxic air contaminants refer to any substance that may cause or contribute to an increase in mortality or serious illness, or that may pose a present or potential hazard to human health. To accomplish the objective of this study, the experimental dataset of nitrogen oxides (NOx), carbon monoxide (CO), sulfur dioxide (SO2), ozone (O3) and dust (PM10) were collected over 3 years (2006-2008) and they are used to create a highly nonlinear model of the PM10 in the Oviedo urban nucleus (Northern Spain) based on the MARS technique. One main objective of this model is to obtain a preliminary estimate of the dependence between PM10 pollutant in the Oviedo urban area at local scale. A second aim is to determine the factors with the greatest bearing on air quality with a view to proposing health and lifestyle improvements. The United States National Ambient Air Quality Standards (NAAQS) establishes the limit values of the main pollutants in the atmosphere in order to ensure the health of healthy people. Firstly, this MARS regression model captures the main perception of statistical learning theory in order to obtain a good prediction of the dependence among the main pollutants in the Oviedo urban area. Secondly, the main advantages of MARS are its capacity to produce simple, easy-to-interpret models, its ability to estimate the contributions of the input variables, and its computational efficiency. Finally, on the basis of these numerical calculations, using the multivariate adaptive regression splines (MARS) technique, conclusions of this research work are exposed.

Diverse users of four urban national forests: participation, preferences, and perceptions

Treesearch

Deborah J. Chavez; David D. Olson

2009-01-01

In natural areas, families and friends can come together to have fun, celebrate important occasions or just relax and take time out. This immense social value is part of the 'glue' of a healthy society (Landy 2008). Several researchers have identified values from natural area visits to include social cohesion, improved mental health, improved physical health...

Cultivating health and well-being through environmental stewardship

Treesearch

Erika Svendsen

2011-01-01

Thanks to long-standing and ongoing scientific research and community engagement, we widely appreciate the health benefits of a clean environment. Trees, native vegetation, parks, and open spaces are valued throughout the world. After a century of urban park development, we are still uncovering the importance of these spaces to a wide range of social and cultural...

Environmental stewardship footprint research: linking human agency and ecosystem health in the Puget Sound region

Treesearch

Kathleen L. Wolf; Dale J. Blahna; Weston Brinkley; Michele Romolini

2013-01-01

Urbanization processes challenge ecosystem health in many metropolitan areas. New policy and program approaches are needed to restore and sustain natural systems as public agencies and organizations face greater demands and declining budgets. Environmental stewardship is an often overlooked intervention strategy, and the full potential of civic engagement by citizens...

Implementation of the State Children's Health Insurance Program: Outreach, Enrollment, and Provider Participation in Rural Areas.

ERIC Educational Resources Information Center

Dunbar, Jennifer L.; Sloane, Harvey I.; Mueller, Curt D.

The state Children's Health Insurance Program (CHIP) funds state programs to help low-income, uninsured children overcome financial barriers to medical care. Previous research found that rural children were more likely to be uninsured than urban children. This report examines the implementation of CHIP and related outreach, enrollment, and…

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.

Urban Form, Air Pollution, and Health.

PubMed

Hankey, Steve; Marshall, Julian D

2017-12-01

Urban form can impact air pollution and public health. We reviewed health-related articles that assessed (1) the relationships among urban form, air pollution, and health as well as (2) aspects of the urban environment (i.e., green space, noise, physical activity) that may modify those relationships. Simulation and empirical studies demonstrate an association between compact growth, improved regional air quality, and health. Most studies are cross-sectional and focus on connections between transportation emissions and land use. The physical and mental health impacts of green space, public spaces that promote physical activity, and noise are well-studied aspects of the urban environment and there is evidence that these factors may modify the relationship between air pollution and health. Urban form can support efforts to design clean, health-promoting cities. More work is needed to operationalize specific strategies and to elucidate the causal pathways connecting various aspects of health.

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

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.

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.

The GREENH-City interventional research protocol on health in all policies.

PubMed

Porcherie, Marion; Vaillant, Zoé; Faure, Emmanuelle; Rican, Stéphane; Simos, Jean; Cantoreggi, Nicola Luca; Heritage, Zoé; Le Gall, Anne Roue; Cambon, Linda; Diallo, Thierno Amadou; Vidales, Eva; Pommier, Jeanine

2017-10-18

This paper presents the research protocol of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project funded by the National Institute for Cancer (Subvention N°2017-003-INCA). In France, health inequities have tended to increase since the late 1980s. Numerous studies show the influence of social, economic, geographic and political determinants on health inequities across the life course. Exposure to environmental factors is uneven across the population and may impact on health and health inequities. In cities, green spaces contribute to creating healthy settings which may help tackle health inequities. Health in All Policies (HiAP) represents one of the key strategies for addressing social and environmental determinants of health inequities. The objective of this research is to identify the most promising interventions to operationalize the HiAP approaches at the city level to tackle health inequities through urban green spaces. It is a participatory interventional research to analyze public policy in real life setting (WHO Healthy Cities). It is a mixed method systemic study with a quantitative approach for the 80 cities and a comparative qualitative multiple case-studies of 6 cities. The research combines 3 different lens: 1/a political analysis of how municipalities apply HiAP to reduce social inequities of health through green space policies and interventions 2/a geographical and topological characterization of green spaces and 3/ on-site observations of the use of green spaces by the inhabitants. City profiles will be identified regarding their HiAP approaches and the extent to which these cities address social inequities in health as part of their green space policy action. The analysis of the transferability of the results will inform policy recommendations in the rest of the Health City Network and widely for the French municipalities. The study will help identify factors enabling the implementation of the HiAP approach at a municipal level, promoting the development of green spaces policies in urban areas in order to tackle the social inequities in health.

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.

Green areas and public health: improving wellbeing and physical activity in the urban context.

PubMed

D'Alessandro, Daniela; Buffoli, Maddalena; Capasso, Lorenzo; Fara, Gaetano Maria; Rebecchi, Andrea; Capolongo, Stefano

2015-01-01

The green areas play an important role in improving the environmental quality and climate of the city. However, despite the undoubted importance of these areas, the benefits to public health are still under investigation. The Authors perform a review of studies on the relationship between health and green areas and describe the main areas for which evidence on this relationship is currently available. They include: effects on air quality, on social cohesion, on mental health, with particular reference to the stress, and on physical activity. Most of the evidence comes from cross-sectional and descriptive studies and the approaches used to measure the association show themselves to be often unsatisfactory. The Authors conclude the review stressing the need for greater integration between the different professionals involved in urban planning and in health care analysis in order to identify research approaches more appropriate to understand such complex issues, striving toward a planning design of green areas that will satisfy both environmental sustainability and health requirements.

Urbanisation and human health in China: spatial features and a systemic perspective.

PubMed

Li, Xinhu; Wang, Cuiping; Zhang, Guoqin; Xiao, Lishan; Dixon, Jane

2012-06-01

Current studies have paid little attention to the dynamism in urban spatial expansion and its possible environmental and health effects or to the health effects of rapid urban environmental change at different points along the urbanisation gradient. This study adopts a public health ecology approach to systematically understand the relationship between urbanisation, urban environmental change and human health in China. Remote sensing image analysis, based on night light data at five different time periods in recent decades, was used to determine changes to the overall urban area. Through a review of the evidence on the relationships between environmental health, urbanisation and health, we advance a pathway framework for explaining urban human health ecology. The Spearman rank correlation coefficient was used to measure the correlation between disease prevalence and urbanisation level, adding a further dimension to a systemic understanding of urban health. Urban areas have been increasing spatially, but unevenly, in recent decades, with medium and small cities also expanding rapidly in the past decade. Urbanisation and urban expansion result in changes to land use/coverage change, the urban environment and the residents' lifestyle, which result in human health problems. Regions with the highest urbanisation level were more inclined to have a high prevalence of chronic disease in recent decades. An ecological public health approach provides insights into the multiple types of data which need to be routinely collected if human disease is not to become a barrier to social and economic development.

Urbanization and health in China, thinking at the national, local and individual levels.

PubMed

Li, Xinhu; Song, Jinchao; Lin, Tao; Dixon, Jane; Zhang, Guoqin; Ye, Hong

2016-03-08

China has the biggest population in the world, and has been experiencing the largest migration in history, and its rapid urbanization has profound and lasting impacts on local and national public health. Under these conditions, a systems understanding on the correlation among urbanization, environmental change and public health and to devise solutions at national, local and individual levels are in urgent need. In this paper, we provide a comprehensive review of recent studies which have examined the relationship between urbanization, urban environmental changes and human health in China. Based on the review, coupled with a systems understanding, we summarize the challenges and opportunities for promoting the health and wellbeing of the whole nation at national, local, and individual levels. Urbanization and urban expansion result in urban environmental changes, as well as residents' lifestyle change, which can lead independently and synergistically to human health problems. China has undergone an epidemiological transition, shifting from infectious to chronic diseases in a much shorter time frame than many other countries. Environmental risk factors, particularly air and water pollution, are a major contributing source of morbidity and mortality in China. Furthermore, aging population, food support system, and disparity of public service between the migrant worker and local residents are important contributions to China's urban health. At the national level, the central government could improve current environmental policies, food safety laws, and make adjustments to the health care system and to demographic policy. At the local level, local government could incorporate healthy life considerations in urban planning procedures, make improvements to the local food supply, and enforce environmental monitoring and management. At the individual level, urban residents can be exposed to education regarding health behaviour choices while being encouraged to take responsibility for their health and to participate in environmental monitoring and management.

Disparities in the use of preventive health care among children with disabilities in Taiwan.

PubMed

Tsai, Wen-Chen; Kung, Pei-Tseng; Wang, Jong-Yi

2012-01-01

Children with disabilities face more barriers accessing preventive health services. Prior research has documented disparities in the receipt of these services. However, most are limited to specific types of disability or care. This study investigates disparities in the use of preventive health care among children with disabilities in Taiwan. Three nationwide databases from the Ministry of the Interior, Bureau of Health Promotion, and National Health Research Institutes were linked to gather related information between 2006 and 2008. A total of 8572 children with disabilities aged 1-7 years were included in this study. Multivariate logistic regression analysis was conducted to adjust for covariates. Nationally, only 37.58% of children with disabilities received preventive health care in 2008. Children with severe and very severe disabilities were less likely to use preventive care than those with mild severity. Children with disabilities from the lowest income family were less likely to have preventive care than other income groups. Urbanization was strongly associated with the receipt of preventive health care. However, surprisingly, urban children with disabilities were less likely to receive preventive care than all others. Under universal health insurance coverage, the overall usage of preventive health care is still low among children with disabilities. The study also identified several disparities in their usage. Potential factors affecting the lack of use deserve additional research. Policymakers should target low socioeconomic brackets and foster education about the importance of preventive care. Mobile health services should be continually provided in those areas in need. Capitation reimbursement and other incentives should be considered in improving the utilization among children with disabilities. Copyright © 2011 Elsevier Ltd. All rights reserved.

Satellite and in-situ monitoring of urban air pollution in relation with children's asthma

NASA Astrophysics Data System (ADS)

Dida, Mariana R.; Zoran, Maria A.

2013-10-01

Urban air pollution and especially aerosols have significant negative health effects on urban population, of which children are most exposed for the rapid increase of asthma disease. An allergic reaction to different allergens is a major contributor to asthma in urban children, but new research suggests that the allergies are just one part of a more complex story. Very early exposure to certain components of air pollution can increase the risk of developing of different allergies by age 7. The epidemiological research on the mutagenic effects of airborne particulate matter pointed their capability to reach deep lung regions, being vehicles of toxic substances. The current study presents a spatio-temporal analysis of the aerosol concentrations in relation with meteorological parameters in two size fractions (PM10 and PM2.5) and possible health effects in Bucharest metropolitan area. Both in-situ monitoring data as well as MODIS Terra/Aqua time-series satellite data of particle matter PM2.5 and PM10 concentrations have been used to qualitatively assess distribution of aerosols in the greater metropolitan are of Bucharest comparative with some other little towns in Romania during 2010- 2011 period. It was found that PM2.5 and PM10 aerosols exhibit their highest concentration mostly in the central part of the towns, mainly due to road traffic as well as in the industrialized parts outside of city's centre. Pediatric asthma can be managed through medications prescribed by a healthcare provider, but the most important aspect is to avoid urban locations with high air pollution concentrations of air particles and allergens.

The public health response to 'do-it-yourself' urbanism.

PubMed

Sibbald, Shannon L; Graham, Ross; Gilliland, Jason

2017-09-01

Greater understanding of the important and complex relationship between the built environment and human health has made 'healthy places' a focus of public health and health promotion. While current literature concentrates on creating healthy places through traditional decision-making pathways (namely, municipal land use planning and urban design processes), this paper explores do-it-yourself (DIY) urbanism: a movement circumventing traditional pathways to, arguably, create healthy places and advance social justice. Despite being aligned with several health promotion goals, DIY urbanism interventions are typically illegal and have been categorized as a type of civil disobedience. This is challenging for public health officials who may value DIY urbanism outcomes, but do not necessarily support the means by which it is achieved. Based on the literature, we present a preliminary approach to health promotion decision-making in this area. Public health officials can voice support for DIY urbanism interventions in some instances, but should proceed cautiously.

Urban sprawl and you: how sprawl adversely affects worker health.

PubMed

Pohanka, Mary; Fitzgerald, Sheila

2004-06-01

Urban sprawl, once thought of as just an environmental issue, is currently gaining momentum as an emerging public health issue worthy of research and political attention. Characteristics seen in sprawling communities include increasing traffic volumes; inadequate public transportation; pedestrian unfriendly streets; and the division of businesses, shops, and homes. These characteristics can affect health in many ways. Greater air pollution contributes to higher asthma and other lung disorder rates. An increased dependence on the automobile encourages a more sedentary lifestyle and can potentially contribute to obesity. The increased danger and stress of long commutes can lead to more accidents, anxiety, and social isolation. Occupational health nurses can become involved by promoting physical activity in the workplace, creating programs for injury prevention and stress management, becoming involved in political smart growth measures, and educating and encouraging colleagues to become active in addressing this issue.

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.

How the built environment affects physical activity: views from urban planning.

PubMed

Handy, Susan L; Boarnet, Marlon G; Ewing, Reid; Killingsworth, Richard E

2002-08-01

The link between the built environment and human behavior has long been of interest to the field of urban planning, but direct assessments of the links between the built environment and physical activity as it influences personal health are still rare in the field. Yet the concepts, theories, and methods used by urban planners provide a foundation for an emerging body of research on the relationship between the built environment and physical activity. Recent research efforts in urban planning have focused on the idea that land use and design policies can be used to increase transit use as well as walking and bicycling. The development of appropriate measures for the built environment and for travel behavior is an essential element of this research. The link between the built environment and travel behavior is then made using theoretical frameworks borrowed from economics, and in particular, the concept of travel as a derived demand. The available evidence lends itself to the argument that a combination of urban design, land use patterns, and transportation systems that promotes walking and bicycling will help create active, healthier, and more livable communities. To provide more conclusive evidence, however, researchers must address the following issues: An alternative to the derived-demand framework must be developed for walking, measures of the built environment must be refined, and more-complete data on walking must be developed. In addition, detailed data on the built environment must be spatially matched to detailed data on travel behavior.

The Relationship between Natural Park Usage and Happiness Does Not Hold in a Tropical City-State

PubMed Central

Saw, Le E.; Lim, Felix K. S.; Carrasco, Luis R.

2015-01-01

Previous studies have shown that contact with urban green spaces can produce positive effects on people's stress, health and well-being levels. However, much of this research has been conducted in the temperate regions of Europe or North America. Additionally, most studies have only compared the effects of urban and natural areas on health and well-being, but not made a finer distinction between different types of urban green spaces. We tested the relationship between well-being and the access or use of different types of green spaces among young adults in Singapore, a tropical city-state. The results showed that extraversion and emotional stability increased subjective well-being, positive affect and life satisfaction and decreased stress and negative affect. In addition, we found that level of physical activity increased positive affect and health problems increased negative affect. Neither access to green spaces nor the use of green spaces in Singapore significantly affected the well-being metrics considered, contradicting findings in the temperate regions of the world. We hypothesize that the differences in temperature and humidity and the higher greenery and biodiversity levels outside parks in Singapore could explain this phenomenon. Our results thus question the universality of the relationship between well-being and park usage and highlight the need for more research into the multifaceted effects of green spaces on well-being in the tropics. PMID:26222280

A method for the inclusion of physical activity-related health benefits in cost-benefit analysis of built environment initiatives.

PubMed

Zapata-Diomedi, Belen; Gunn, Lucy; Giles-Corti, Billie; Shiell, Alan; Lennert Veerman, J

2018-01-01

The built environment has a significant influence on population levels of physical activity (PA) and therefore health. However, PA-related health benefits are seldom considered in transport and urban planning (i.e. built environment interventions) cost-benefit analysis. Cost-benefit analysis implies that the benefits of any initiative are valued in monetary terms to make them commensurable with costs. This leads to the need for monetised values of the health benefits of PA. The aim of this study was to explore a method for the incorporation of monetised PA-related health benefits in cost-benefit analysis of built environment interventions. Firstly, we estimated the change in population level of PA attributable to a change in the built environment due to the intervention. Then, changes in population levels of PA were translated into monetary values. For the first step we used estimates from the literature for the association of built environment features with physical activity outcomes. For the second step we used the multi-cohort proportional multi-state life table model to predict changes in health-adjusted life years and health care costs as a function of changes in PA. Finally, we monetised health-adjusted life years using the value of a statistical life year. Future research could adapt these methods to assess the health and economic impacts of specific urban development scenarios by working in collaboration with urban planners. Copyright © 2017 Elsevier Inc. All rights reserved.

[Environmental justice as an approach to tackle environmental health inequalities].

PubMed

Bolte, Gabriele; Bunge, Christiane; Hornberg, Claudia; Köckler, Heike

2018-06-01

Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

Determinants, Health Problems, and Food Insecurity in Urban Areas of the Largest City in Cape Verde.

PubMed

Craveiro, Isabel; Alves, Daniela; Amado, Miguel; Santos, Zélia; Fortes, Argentina Tomar; Delgado, António Pedro; Correia, Artur; Gonçalves, Luzia

2016-11-22

Urbanization processes are intertwined with nutritional transition because there is easier access to food of low nutritional quality at reduced prices, changing dietary patterns and leading to an increase of non-communicable chronic diseases. This study aims to understand the perceptions for high blood pressure, obesity, and alcoholism, describing some interactions of these dimensions in the problem of food security in the city of Praia. A qualitative study was carried out under the framework of the research project "UPHI-STAT: Urban Planning and Health Inequalities-moving from macro to micro statistics". Ten focus groups were conducted in three urban areas with distinct characteristics in the city of Praia, with a total of 48 participants. Participants reported frequent consumption of foods with poor nutritional quality, understanding the potential danger in terms of food security in the city of Praia. Easy access to and high levels of alcohol consumption, and poor quality of traditional drinks were mentioned by participants in the study areas. The impact of the economic situation on the possibility of access to safe and healthy options emerged as a differentiating factor.

A Disadvantaged Advantage in Walkability: Findings from ...

EPA Pesticide Factsheets

Urban form-the structure of the built environment-can influence physical activity, yet little is known about how walkable design differs according to neighborhood sociodemographic composition. We studied how walkable urban form varies by neighborhood sociodemographic composition, region, and urbanicity across the United States. Using linear regression models and 2000-2001 US Census data, we investigated the relationship between 5 neighborhood census characteristics (income, education, racial/ethnic composition, age distribution, and sex) and 5 walkability indicators in almost 65,000 census tracts in 48 states and the District of Columbia. Data on the built environment were obtained from the RAND Corporation's (Santa Monica, California) Center for Population Health and Health Disparities (median block length, street segment, and node density) and the US Geological Survey's National Land Cover Database (proportion open space and proportion highly developed). Disadvantaged neighborhoods and those with more educated residents were more walkable (i.e., shorter block length, greater street node density, more developed land use, and higher density of street segments). However, tracts with a higher proportion of children and older adults were less walkable (fewer street nodes and lower density of street segments), after adjustment for region and level of urbanicity. Research and policy on the walkability-health link should give nuanced attention to the gap between perso

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.

[Association analysis between urbanization and non-communicable diseases and health-related behavior].

PubMed

Liu, G F; Sun, M P; Wang, Z Y; Jian, W Y

2016-06-18

To explore the association between different urbanization levels and non-communicable diseases (NCDs) in China and provide suggestions on designing relevant health policies in the urbanization process. We obtained health-related data from China Health and Retirement Longitudinal Study (CHARLS) 2011. This study used multistage sampling in design stage and covered 150 districts/counties, representative at the levels of the country. Geo-information system (GIS) method was used to get district areas data, and in combination with the Sixth National Census population data, we computed the population density which was regarded as the proxy variable of urbanization level in every city. The Logistic model was used to explore the effect of urbanization level on hypertension, diabetes, smoking, drinking, overweight and obesity. Compared with other cities in China, Shanghai and Shenzhen, with the population density of more than 3 000 people per km(2), were the cities with highest urbanization level. From the map of urbanization distribution across China, it was found that the urbanization levels of the northwestern districts were lower than those of the southeastern and coastal districts. The hypertension rate increased with the development of urbanization but there was no statistical significance. The proportion of patients with diabetes went up first and then saw a decrease trend in the process of urbanization. Drinking rate, overweight rate and obesity rate had similar trends, falling to their lowest point when urbanization level equaled 737,1 186 and 1 353 people per km(2) respectively and then experienced upward trends. By contrast, smoking rate declined first and then went up (the turning point was 1 029 people per km(2)). Different urbanization levels have different effects on NCDs, health-related behavior, overweight and obesity. Low urbanization level may create negative impact on health while high level can pose positive effect and increase people's health condition possibly due to the improvement of health care accessibility and the quality of living environment. Policy-makers should specially focus on different residents'health problems in different periods of urbanization, such as the impact of environmental pollution, health resources' allocation and accessibility of health services. It is necessary to reduce or avoid the negative effect of urbanization on NCDs during the local development process to face the NCDs' threat.

Influence of health-related quality of life on health service utilization in Chinese rural-to-urban female migrant workers.

PubMed

Lu, Chu-Hong; Wang, Pei-Xi; Lei, Yi-Xiong; Luo, Zhong-Cheng

2014-08-15

Rural-to-urban migrant workers have been increasing rapidly in China over recent decades. Health related quality of life (HRQOL) may affect health service utilization. There is a lack of data on HRQOL in relation to health service utilization in Chinese rural-to-urban migrant workers. This study was aimed to explore the influence of HRQOL on health service utilization in Chinese rural-to-urban female migrant workers. This was a cross-sectional survey of 1,438 female rural-to-urban migrant workers in Shenzhen-Dongguan economic zone, China in 2013. HRQOL was assessed by the 36-items Health Survey Short Form (SF-36). Health service utilization was measured by any physician visit over the recent two weeks and any hospitalization over the last 1-year (annual hospitalization). Clustered logistic regression was used to analyze the influence of HRQOL on health service utilization. Lower scores in three HRQOL domains (bodily pain, general health, role physical) were associated with more frequent health service utilization in female rural-to-urban migrant workers. Bodily pain and general health were associated with an independent influence of 15.6% on the risk of recent two-week physician visit, while role physical and general health were associated with an independent influence of 21.2% on the risk of annual hospitalization. The independent influence of HRQOL on health service utilization was smaller than that of socio-demographic and health-related variables. HRQOL may have a modest influence on health service utilization in Chinese rural-to-urban female migrant workers - an underprivileged population in urban China.

Landscape care of urban vacant properties and implications for health and safety: Lessons from photovoice.

PubMed

Sampson, Natalie; Nassauer, Joan; Schulz, Amy; Hurd, Kathleen; Dorman, Cynthia; Ligon, Khalil

2017-07-01

Care of vacant properties in urban environments is of particular interest to planners and residents alike. We report on a photovoice project completed by community leaders, researchers, and residents in two Detroit neighborhoods experiencing longtime systemic disinvestment. Participants photographed and discussed examples of care in a series of three focus groups in each neighborhood. Analyses highlight how acts of landscape care and visible cues to care contribute to changes in physical and social environments, and explore various links to health. We suggest theoretical and practical applications of residents' perspectives on landscape care and identify implications for well-being and neighborhood stability. Copyright © 2017 Elsevier Ltd. All rights reserved.

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

Urban air pollution, poverty, violence and health--Neurological and immunological aspects as mediating factors.

PubMed

Kristiansson, Marianne; Sörman, Karolina; Tekwe, Carmen; Calderón-Garcidueñas, Lilian

2015-07-01

Rapid rural-urban migration has created overcrowded areas characterized by concentrated poverty and increases in indoor and outdoor air pollutants. These "hotspots" constitute an increased risk of violence and disease outbreaks. We hypothesize that the effects of poverty and associated air pollution-related stress on impaired cognitive skills are mediated by inflammatory cytokines. A research framework is proposed, encompassing (i) an epidemiological investigation of associations between poverty, high concentrations of air pollutants, violence and health, (ii) a longitudinal follow-up of working memory capacities and inflammatory markers, and (iii) intervention programs aiming to strengthen employability and decreased exposures to toxic air pollutants. Copyright © 2015 Elsevier Inc. All rights reserved.

Building oral health research infrastructure: the first national oral health survey of Rwanda.

PubMed

Morgan, John P; Isyagi, Moses; Ntaganira, Joseph; Gatarayiha, Agnes; Pagni, Sarah E; Roomian, Tamar C; Finkelman, Matthew; Steffensen, Jane E M; Barrow, Jane R; Mumena, Chrispinus H; Hackley, Donna M

2018-01-01

Oral health affects quality of life and is linked to overall health. Enhanced oral health research is needed in low- and middle-income countries to develop strategies that reduce the burden of oral disease, improve oral health and inform oral health workforce and infrastructure development decisions. To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies. In this cross-sectional study, sample size and site selection were based on the World Health Organization (WHO) Oral Health Surveys Pathfinder stratified cluster methodologies. Randomly selected 15 sites included 2 in the capital city, 2 other urban centers and 11 rural locations representing all provinces and rural/urban population distribution. A minimum of 125 individuals from each of 5 age groups were included at each site. A Computer Assisted Personal Instrument (CAPI) was developed to administer the study instrument. Nearly two-thirds (64.9%) of the 2097 participants had caries experience and 54.3% had untreated caries. Among adults 20 years of age and older, 32.4% had substantial oral debris and 60.0% had calculus. A majority (70.6%) had never visited an oral health provider. Quality-of-life challenges due to oral diseases/conditions including pain, difficulty chewing, self-consciousness, and difficulty participating in usual activities was reported at 63.9%, 42.2% 36.2%, 35.4% respectively. The first National Oral Health Survey of Rwanda was a collaboration of the Ministry of Health of Rwanda, the University of Rwanda Schools of Dentistry and Public Health, the Rwanda Dental Surgeons and Dental (Therapists) Associations, and Tufts University and Harvard University Schools of Dental Medicine. The international effort contributed to building oral health research capacity and resulted in a national oral health database of oral disease burden. This information is essential for developing oral disease prevention and management strategies as well as oral health workforce and infrastructure.

Building oral health research infrastructure: the first national oral health survey of Rwanda

PubMed Central

Morgan, John P.; Ntaganira, Joseph; Gatarayiha, Agnes; Pagni, Sarah E.; Roomian, Tamar C.; Finkelman, Matthew; Steffensen, Jane E. M.; Barrow, Jane R.; Mumena, Chrispinus H.

2018-01-01

ABSTRACT Background: Oral health affects quality of life and is linked to overall health. Enhanced oral health research is needed in low- and middle-income countries to develop strategies that reduce the burden of oral disease, improve oral health and inform oral health workforce and infrastructure development decisions. Objective: To implement the first National Oral Health Survey of Rwanda to assess the oral disease burden and inform oral health promotion strategies. Methods: In this cross-sectional study, sample size and site selection were based on the World Health Organization (WHO) Oral Health Surveys Pathfinder stratified cluster methodologies. Randomly selected 15 sites included 2 in the capital city, 2 other urban centers and 11 rural locations representing all provinces and rural/urban population distribution. A minimum of 125 individuals from each of 5 age groups were included at each site. A Computer Assisted Personal Instrument (CAPI) was developed to administer the study instrument. Results: Nearly two-thirds (64.9%) of the 2097 participants had caries experience and 54.3% had untreated caries. Among adults 20 years of age and older, 32.4% had substantial oral debris and 60.0% had calculus. A majority (70.6%) had never visited an oral health provider. Quality-of-life challenges due to oral diseases/conditions including pain, difficulty chewing, self-consciousness, and difficulty participating in usual activities was reported at 63.9%, 42.2% 36.2%, 35.4% respectively. Conclusion: The first National Oral Health Survey of Rwanda was a collaboration of the Ministry of Health of Rwanda, the University of Rwanda Schools of Dentistry and Public Health, the Rwanda Dental Surgeons and Dental (Therapists) Associations, and Tufts University and Harvard University Schools of Dental Medicine. The international effort contributed to building oral health research capacity and resulted in a national oral health database of oral disease burden. This information is essential for developing oral disease prevention and management strategies as well as oral health workforce and infrastructure. PMID:29860930

Can Geographic Bridging Social Capital Improve the Health of People Who Live in Deprived Urban Neighborhoods?

PubMed

Kim, Chang-O; Cho, Byong-Hee

2016-10-01

The growing number of people living in deprived urban neighborhoods, which often have unhealthy environments, is of growing concern to inequality researchers. Social capital could be a resource to help such communities get ahead. In this study, we examined the differential effects of bonding and bridging social capital on self-rated health using two operational definitions, which we call personal and geographic social capital. Bonding and bridging social capital were operationally distinguished as respondents' perceived similarity to other members of a group with respect to personal characteristics (personal social capital) or as structural similarity with respect to geographical location (geographic social capital). The results showed that although both bonding and bridging social capital as defined by person-based criteria were associated with increased odds of self-rated health compared to those who reported zero participation, when defined by place-based criteria, only bridging social capital was associated with increased odds of self-rated health; no clear association was found between health and belonging to groups within the neighborhood, so-called geographic bonding social capital. The present study suggests that geographic bridging social capital can function as linking social capital that enables an upward approach depending on the political and economic contexts of urbanization. © The Author(s) 2015.

Application of Satellite Remote Sensing to Identify Climatic and Anthropogenic Changes Related to Water and Health Conditions in Emerging Megacities

NASA Astrophysics Data System (ADS)

Akanda, A. S.; Serman, E. A.; Jutla, A.

2014-12-01

By 2050, more than 70% of the world's population is expected to be living in a city. In many of the urbanizing regions in Asia and Africa, most new development is taking place without adequate urban or regional planning, and a majority population is crowded into densely populated unplanned settlements, also known as slums. During the same period, precipitation and temperature patterns are likely to see significant changes in many of these regions while coastal megacities will have to accommodate sea-level rise in their ecosystems. The rapid increase in population is usually observed in fringes of the urban sprawl without adequate water or sanitation facilities or access to other municipal amenities (such as utilities, healthcare, and education). Collectively, these issues make the ever increasing slum dwellers in emerging megacities significantly vulnerable to a combination of climatic and anthropogenic threats. However, how the growth of unplanned urban and peri-urban sprawl and simultaneous change in climatic patterns have impacted public health in the emerging megacities remain largely unexplored due to lack of readily available and usable data. We employ a number of Remote Sensing products (GRACE, LANDSAT, MODIS) to bridge above knowledge gaps and to identify relevant hydrologic and anthropogenic changes in emerging megacities that are most vulnerable due to the climate-water-health nexus. We explore one of the largest and the fastest growing megacities in the world - Dhaka, Bangladesh - on identifying and investigating the changes in the water environment and growth of slum areas, and impact on water services and health outcomes. The hydroclimatology of South Asia is highly seasonal and the asymmetric availability of water affects vast areas of Bangladesh differently in space and time, exposing the population of Dhaka region to both droughts and floods and periodic spring-fall outbreaks of diarrheal diseases, such as cholera and rotavirus. This research focuses on stretching this understanding to water and health implications in this growing megacity and adjoining slum areas, and how satellite remote sensing data products and derived knowledge can inform urban planning, water management, and public health sectors to adapt to these climatic and anthropogenic changes for the benefit of societies.

Active travel behavior and spatial-temporal land use mixing : final report.

DOT National Transportation Integrated Search

2017-06-01

Smart growth policies have often emphasized the importance of land use mix as an intervention beholding of lasting urban planning and public health benefits. Past transportation-land use research has identified potential efficiency gains achieved by ...

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.

Improving Urban MCH Linkages: Highlights of the 1993 Urban Maternal and Child Health Leadership Conference.

ERIC Educational Resources Information Center

Peck, Magda G., Ed.

This report contains selected presentations from the 1993 Urban Maternal and Child Health Leadership Conference. Following welcoming remarks by Carolyn Slack, two presentations discuss improving urban maternal and child health (MCH) linkages. "Pittsburgh's Alliance for Infants," by Virginia Bowman, describes a comprehensive in-home…

The longitudinal effects of neighbourhood social and material deprivation change on psychological distress in urban, community-dwelling Canadian adults.

PubMed

Blair, A; Gariépy, G; Schmitz, N

2015-07-01

The purpose of this study was to assess how longitudinal changes in neighbourhood material and social deprivation affect distress outcomes in adult Canadians. This study used a prospective cohort approach. We paired data from 2745 urban participants of Canada's National Population Health Survey-who completed the Kessler 6-Item psychological distress screening tool at baseline and follow-up-with neighbourhood social and material deprivation data from the census-based Pampalon Deprivation Index. Data were paired using participants' postal code. We conducted multiple linear regression models, which were stratified by baseline deprivation level and controlled for key confounders. Most participants lived in neighbourhoods that did not change drastically in social or material deprivation level during the six years between baseline and follow-up. We found that a worsening of material settings was significantly associated with worsening distress scores at follow-up. This finding is discussed in the context of existing literature, and made relevant for urban health research and policy. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Integrating human and natural systems in community psychology: an ecological model of stewardship behavior.

PubMed

Moskell, Christine; Allred, Shorna Broussard

2013-03-01

Community psychology (CP) research on the natural environment lacks a theoretical framework for analyzing the complex relationship between human systems and the natural world. We introduce other academic fields concerned with the interactions between humans and the natural environment, including environmental sociology and coupled human and natural systems. To demonstrate how the natural environment can be included within CP's ecological framework, we propose an ecological model of urban forest stewardship action. Although ecological models of behavior in CP have previously modeled health behaviors, we argue that these frameworks are also applicable to actions that positively influence the natural environment. We chose the environmental action of urban forest stewardship because cities across the United States are planting millions of trees and increased citizen participation in urban tree planting and stewardship will be needed to sustain the benefits provided by urban trees. We used the framework of an ecological model of behavior to illustrate multiple levels of factors that may promote or hinder involvement in urban forest stewardship actions. The implications of our model for the development of multi-level ecological interventions to foster stewardship actions are discussed, as well as directions for future research to further test and refine the model.

Noise pollution and annoyance: an urban soundscapes study.

PubMed

de Paiva Vianna, Karina Mary; Alves Cardoso, Maria Regina; Rodrigues, Rui Manuel Calejo

2015-01-01

Since 1972, the World Health Organization (WHO) has declared noise as a pollutant. Over the last decades, the quality of the urban environment has attracted the interest of researchers due to the growing urban sprawl, especially in developing countries. The objective of this study was to evaluate the effects of noise exposure in six urban soundscapes: Areas with high and low levels of noise in scenarios of leisure, work, and home. Cross-sectional study. The study was conducted in two steps: Evaluation of noise levels, with the development of noise maps, and health related inquiries. 180 individuals were interviewed, being 60 in each scenario, divided into 30 exposed to high level of noise and 30 to low level. Chi-Square test and Ordered Logistic Regression Model (P < 0,005). 70% of the interviewees reported noticing some source of noise in the selected scenarios and it was observed an association between exposure and perception of some source of noise (P < 0.001). 41.7% of the interviewees reported some degree of annoyance, being that this was associated with exposure (P < 0.001). There was also an association between exposure in different scenarios and reports of poor quality of sleep (P < 0.001). In the scenarios of work and home, the chance of reporting annoyance increased when compared with the scenario of leisure. We conclude that the use of this sort of assessment may clarify the relationship between urban noise exposure and health.

Noise pollution and annoyance: An urban soundscapes study

PubMed Central

de Paiva Vianna, Karina Mary; Alves Cardoso, Maria Regina; Rodrigues, Rui Manuel Calejo

2015-01-01

Since 1972, the World Health Organization (WHO) has declared noise as a pollutant. Over the last decades, the quality of the urban environment has attracted the interest of researchers due to the growing urban sprawl, especially in developing countries. The objective of this study was to evaluate the effects of noise exposure in six urban soundscapes: Areas with high and low levels of noise in scenarios of leisure, work, and home. Cross-sectional study. The study was conducted in two steps: Evaluation of noise levels, with the development of noise maps, and health related inquiries. 180 individuals were interviewed, being 60 in each scenario, divided into 30 exposed to high level of noise and 30 to low level. Chi-Square test and Ordered Logistic Regression Model (P < 0,005). 70% of the interviewees reported noticing some source of noise in the selected scenarios and it was observed an association between exposure and perception of some source of noise (P < 0.001). 41.7% of the interviewees reported some degree of annoyance, being that this was associated with exposure (P < 0.001). There was also an association between exposure in different scenarios and reports of poor quality of sleep (P < 0.001). In the scenarios of work and home, the chance of reporting annoyance increased when compared with the scenario of leisure. We conclude that the use of this sort of assessment may clarify the relationship between urban noise exposure and health. PMID:25913551

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

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.

Reconsidering the effects of poverty and social support on health: a 5-year longitudinal test of the stress-buffering hypothesis.

PubMed

Moskowitz, David; Vittinghoff, Eric; Schmidt, Laura

2013-02-01

Prior research in the general population has found that social support can buffer the adverse effects of stressors on health. However, both stressors and social support may be qualitatively different for those living in urban poverty. We examined the effects of social support and poverty-specific stressors on self-rated health. We used data from the Welfare Client Longitudinal Survey (WCLS), a 5-year longitudinal study of 718 public aid recipients. We measured received social support and "net social support," defined as the difference between support received and that given to others. We used restricted cubic splines to model the stress-buffering effects of social support on self-rated health as a function of stressful life events and neighborhood disorder. Increased exposure to stressors was associated with poorer self-rated health. Evidence of stress buffering was confined to those with the heaviest exposure to stressors, and its effects decreased across increasing levels of social support. Analyses using net social support had generally more modest effects than those using received social support. Social support does not buffer the effects of stressors on health uniformly for individuals living in conditions of urban poverty. Researchers and policymakers should be cautious in overestimating the beneficial effects that social support may have on health for marginalized populations.

Nearby nature—A cost-effective prescription for better community health?

Treesearch

Andrea Watts; Kathleen Wolf; Stephen C. Grado; Marcus Measells

2018-01-01

A balanced diet and regular exercise are fundamental for good health, and a daily dose of nature may be equally important. Nearly 40 years of research has demonstrated that “metro nature”—nature found in urban environments, such as parks or tree-lined streets—provides positive and measurable health benefits and improves people’s quality of life.

The rural nurse work environment and structural empowerment.

PubMed

Krebs, Julianne P; Madigan, Elizabeth A; Tullai-McGuinness, Susan

2008-02-01

Rural health care organizations struggle to attract and retain nurses, yet much of the research has focused on characteristics of the nurse work environment or empowerment in urban hospitals. The purpose of this study was to examine the nurse work environment in rural areas across settings by describing the relationship between structural empowerment and characteristics of the nurse work environment. Nurses ( N = 97) working in home care agencies and hospitals were surveyed. Significant differences were found between the groups, with home care nurses having significantly higher empowerment scores than medical/surgical nurses. A strong correlation was found between characteristics of the nurse work environment and empowerment. Policy makers are using evidence to guide development of policies, but much of the research has been conducted in urban hospital settings. This study begins to provide evidence that differences exist between urban and rural areas and between practice settings.

Differential impacts of social support on mental health: A comparison study of Chinese rural-to-urban migrant adolescents and their urban counterparts in Beijing, China.

PubMed

Zhuang, Xiao Yu; Wong, Daniel Fu Keung

2017-02-01

The number of internal migrant children in China has reached 35.8 million by the end of 2010. Previous studies revealed inconsistent findings regarding the mental health status of rural-to-urban migrant adolescents, as well as the impact of peer, teacher and parental support on the mental health of Chinese adolescent migrants. Using a comparative approach, this study attempted to compare the mental health status between migrant and urban-born adolescents and to clarify the specific roles of different sources of social support in the mental health of migrant and urban adolescents. A cross-sectional survey using a cluster convenience sampling strategy was performed in Beijing, China. A structured questionnaire was filled out by 368 rural-to-urban migrant adolescents and 325 urban-born adolescents. A significant difference was found only for positive affect (PA) but not for negative affect (NA) between the two groups, favouring the urban-born adolescents. Social support from all the three sources were all predictive of PA among rural-to-urban migrant adolescents, while only peer support contributed to PA among urban-born adolescents. Unexpectedly, teachers' support contributed to an increase in NA among urban-born adolescents. The findings contribute to understanding of the mental health status of migrant adolescents in China and the differential impact of the various sources of social support on migrant and urban-born adolescents. Also the findings may inform the development of mental health services and programmes that can potentially benefit a large number of internal migrant adolescents in China.

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.

Feasibility of screening and prevalence of prenatal depression in an obstetric setting in Spain.

PubMed

de la Fe Rodríguez-Muñoz, María; Le, Huynh-Nhu; de la Cruz, Ivette Vargas; Crespo, María Eugenia Olivares; Méndez, Nuria Izquierdo

2017-08-01

Prenatal depression is a significant public health problem and one of the main risk factors for postpartum depression. Limited research in perinatal depression has been conducted in Spain. The objectives of this study was to: (1) examine the feasibility of integrating a screening program for prenatal depression in an obstetrics setting in a large urban hospital in Spain; and (2) provide an initial estimate of the prevalence rate of the severity of depressive symptoms during pregnancy. Screening for prenatal depression was conducted during the first trimester in an obstetrics setting in an urban hospital in Madrid, Spain 2014-2015. The Patient Health Questionnaire (PHQ-9) was used as the main screener. Of the 730 women asked to complete the screening protocol, 445 (60.9%) completed the PHQ-9 during the first trimester. Those who did not complete the screening were more likely to be immigrants and did not read Spanish. The prevalence of moderate to high severity of prenatal depressive symptoms prenatal depressive is 14.8% (PHQ-9≥10). It is possible to integrate screening for prenatal depression in an urban obstetrics setting, but there are significant structural barriers to implementation. The prevalence of significant prenatal depressive symptoms is similar to previous research in Spain and adds to the limited research in this area. Copyright © 2017 Elsevier B.V. All rights reserved.

A study on satisfaction with publicly financed health services in China.

PubMed

Zhai, Shaoguo; Wang, Pei; Wang, Anli; Dong, Quanfang; Cai, Jiaoli; Coyte, Peter C

2017-08-28

With implementation of Chinese universal healthcare, the performance of urban and rural residents' healthcare and the degree of satisfaction with publicly financed health services have become a hot issue in assessing health reforms in China. An evaluation model of health services in community and evaluation indexes of health-system performance have been put forward in related researches. This study examines variation in satisfaction with publicly financed health services among urban and rural residents in five Chinese cities and assesses their determinants. The data are derived from a survey of 1198 urban and rural residents from five nationally representative regions concerning their perceptions of satisfaction with China's publicly financed health services. The respondents assessed their degree of satisfaction with publicly financed health services on a 5-point Likert scale. It is a kind of questionaire scale that features the answers for 1-5 points labeled very unsatisfied, unsatisfied, neither unsatisfied nor satisfied, satisfied and very satisfied linking to each factor or variable, where a score of 1 reflects the lowest degree of satisfaction and a score of 5 represents the highest degree. The logistic regression methods are used to identify the variables into its determining components. The overall satisfaction degree representing satisfaction of all factors (variables) is 3.02, which is at the middle level of a 1-5 Likert scale, inferring respondents' neutral attitude to publicly financed health services. According to the correlation test, the factors with characteristic root greater than 0.5 are chosen to take the factor analysis and 12 extracted factors can explain 77.97% of original 18 variables' total variance. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for both urban and rural residents. What can be done to increase the degree of satisfaction with health services needs to be considered based on our findings. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for both urban and rural residents. Therefore, with improvements in health records, timely vaccination, elder care for women or elder, pediatric care and major psychosis management, degree of satisfaction with publicly financed health services are likely to grow.

Promoting careers in health care for urban youth: What students, parents and educators can teach us

PubMed Central

Holden, Lynne; Rumala, Bernice; Carson, Patricia; Siegel, Elliot

2014-01-01

There are many obstacles that urban youth experience in pursuing health careers, but the benefits of diversifying the classroom and workforce are clear. This is especially true today as educators and policymakers seek to enhance underrepresented minority students’ access to health careers, and also achieve the health workforce needed to support the Affordable Care Act. The creation of student pipeline programs began more than 40 years ago, but success has been equivocal. In 2008, Mentoring in Medicine (MIM) conducted a research project to identify how students learn about health careers; develop strategies for an integrated, experiential learning program that encourages underrepresented minority students to pursue careers in health; and translate these into best practices for supporting students through their entire preparatory journey. Six focus groups were conducted with educators, students, and their parents. The inclusion of parents was unusual in studies of this kind. The outcome yielded important and surprising differences between student and parent knowledge, attitudes and beliefs. They informed our understanding of the factors that motivate and deter underrepresented minority students to pursue careers in health care. Specific programmatic strategies emerged that found their place in the subsequent development of new MIM programming that falls into the following three categories: community-based, school-based and Internet based. Best practices derived from these MIM programs are summarized and offered for consideration by other health career education program developers targeting underrepresented minority students, particularly those located in urban settings. PMID:25580044

Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods

PubMed Central

Zhang, Yang; van Dijk, Terry; Tang, Jianjun; van den Berg, Agnes E.

2015-01-01

The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents’ emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223) of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces. PMID:26569280

Green Space Attachment and Health: A Comparative Study in Two Urban Neighborhoods.

PubMed

Zhang, Yang; van Dijk, Terry; Tang, Jianjun; van den Berg, Agnes E

2015-11-12

The positive relationships between urban green space and health have been well documented. Little is known, however, about the role of residents' emotional attachment to local green spaces in these relationships, and how attachment to green spaces and health may be promoted by the availability of accessible and usable green spaces. The present research aimed to examine the links between self-reported health, attachment to green space, and the availability of accessible and usable green spaces. Data were collected via paper-mailed surveys in two neighborhoods (n = 223) of a medium-sized Dutch city in the Netherlands. These neighborhoods differ in the perceived and objectively measured accessibility and usability of green spaces, but are matched in the physically available amount of urban green space, as well as in demographic and socio-economic status, and housing conditions. Four dimensions of green space attachment were identified through confirmatory factor analysis: place dependence, affective attachment, place identity and social bonding. The results show greater attachment to local green space and better self-reported mental health in the neighborhood with higher availability of accessible and usable green spaces. The two neighborhoods did not differ, however, in physical and general health. Structural Equation Modelling confirmed the neighborhood differences in green space attachment and mental health, and also revealed a positive path from green space attachment to mental health. These findings convey the message that we should make green places, instead of green spaces.

The impact of urban regeneration programmes on health and health-related behaviour: Evaluation of the Dutch District Approach 6.5 years from the start.

PubMed

Ruijsbroek, Annemarie; Wong, Albert; Kunst, Anton E; van den Brink, Carolien; van Oers, Hans A M; Droomers, Mariël; Stronks, Karien

2017-01-01

Large-scale regeneration programmes to improve the personal conditions and living circumstances in deprived areas may affect health and the lifestyle of the residents. Previous evaluations concluded that a large-scale urban regeneration programme in the Netherlands had some positive effects within 3.5 years. The aim of the current study was to evaluate the effects at the longer run. With a quasi-experimental research design we assessed changes in the prevalence of general health, mental health, physical activity, overweight, obesity, and smoking between the pre-intervention (2003-04 -mid 2008) and intervention period (mid 2008-2013-14) in 40 deprived target districts and comparably deprived control districts. We used the Difference-in-Difference (DiD) to assess programme impact. Additionally, we stratified analyses by sex and by the intensity of the regeneration programme. Changes in health and health related behaviours from pre-intervention to the intervention period were about equally large in the target districts as in control districts. DiD impact estimates were inconsistent and not statistically significant. Sex differences in DiD estimates were not consistent or significant. Furthermore, DiD impact estimates were not consistently larger in target districts with more intensive intervention programmes. We found no evidence that this Dutch urban regeneration programme had an impact in the longer run on self-reported health and related behaviour at the area level.

Promoting careers in health care for urban youth: What students, parents and educators can teach us.

PubMed

Holden, Lynne; Rumala, Bernice; Carson, Patricia; Siegel, Elliot

2014-01-01

There are many obstacles that urban youth experience in pursuing health careers, but the benefits of diversifying the classroom and workforce are clear. This is especially true today as educators and policymakers seek to enhance underrepresented minority students' access to health careers, and also achieve the health workforce needed to support the Affordable Care Act. The creation of student pipeline programs began more than 40 years ago, but success has been equivocal. In 2008, Mentoring in Medicine (MIM) conducted a research project to identify how students learn about health careers; develop strategies for an integrated, experiential learning program that encourages underrepresented minority students to pursue careers in health; and translate these into best practices for supporting students through their entire preparatory journey. Six focus groups were conducted with educators, students, and their parents. The inclusion of parents was unusual in studies of this kind. The outcome yielded important and surprising differences between student and parent knowledge, attitudes and beliefs. They informed our understanding of the factors that motivate and deter underrepresented minority students to pursue careers in health care. Specific programmatic strategies emerged that found their place in the subsequent development of new MIM programming that falls into the following three categories: community-based, school-based and Internet based. Best practices derived from these MIM programs are summarized and offered for consideration by other health career education program developers targeting underrepresented minority students, particularly those located in urban settings.

Public open space, physical activity, urban design and public health: Concepts, methods and research agenda.

PubMed

Koohsari, Mohammad Javad; Mavoa, Suzanne; Villanueva, Karen; Sugiyama, Takemi; Badland, Hannah; Kaczynski, Andrew T; Owen, Neville; Giles-Corti, Billie

2015-05-01

Public open spaces such as parks and green spaces are key built environment elements within neighbourhoods for encouraging a variety of physical activity behaviours. Over the past decade, there has been a burgeoning number of active living research studies examining the influence of public open space on physical activity. However, the evidence shows mixed associations between different aspects of public open space (e.g., proximity, size, quality) and physical activity. These inconsistencies hinder the development of specific evidence-based guidelines for urban designers and policy-makers for (re)designing public open space to encourage physical activity. This paper aims to move this research agenda forward, by identifying key conceptual and methodological issues that may contribute to inconsistencies in research examining relations between public open space and physical activity. Copyright © 2015 Elsevier Ltd. All rights reserved.

Stakeholder benefit from depression disease management: differences by rurality?

PubMed

Xu, Stanley; Rost, Kathryn; Dong, Fran; Dickinson, L Miriam

2011-01-01

Despite increasing consensus about the value of depression disease management programs, the field has not identified which stakeholders should absorb the relatively small additional costs associated with these programs. This paper investigates whether two proposed stakeholders (health plans and employer purchasers) economically benefit from depression care management (reduced outpatient utilization and work costs, respectively) in two delivery systems (rural and urban). This study examined the main and differential effects of depression care management on outpatient utilization and work costs over 24 months in a preplanned secondary analysis of 479 depressed patients from rural and urban primary care practices in a randomized controlled trial. Over 24 months, the intervention did not significantly reduce outpatient utilization costs in the entire cohort (-$191, 95% confidence interval (CI)=-$2,083 to $1,647), but it did decrease work costs (-$1,970, 95% CI=-$3,934 to -$92). While not statistically significant, rural-urban differences in work costs were in the same direction, while rural-urban differences in utilization costs differed in direction. These findings provide preliminary evidence that employers who elect to cover depression care management costs should receive comparable economic benefits in the rural and urban employees they insure. Given the limited sample size, further research may be needed to determine whether health plans who elect to cover depression care management costs will receive comparable economic benefits in the rural and urban enrollees they insure.

Urban-Rural Disparity of Generics Prescription in Taiwan: The Example of Dihydropyridine Derivatives

PubMed Central

Chiang, Shu-Chiung; Chou, Li-Fang

2014-01-01

The aim of the current study was to investigate the urban-rural disparity of prescribing generics, which were usually cheaper than branded drugs, within the universal health insurance system in Taiwan. Data sources were the cohort datasets of National Health Insurance Research Database with claims data in 2010. The generic prescribing ratios of dihydropyridine (DHP) derivatives (the proportion of DHP prescribed as generics to all prescribed DHP) of medical facilities were examined against the urbanization levels of the clinic location. Among the total 21,606,914 defined daily doses of DHP, 35.7% belonged to generics. The aggregate generic prescribing ratio rose from 6.7% at academic medical centers to 15.3% at regional hospitals, 29.4% at community hospital, and 66.1% at physician clinics. Among physician clinics, the generic prescribing ratio in urban areas was 63.9 ± 41.0% (mean ± standard deviation), lower than that in suburban (69.6 ± 38.7%) and in rural (74.1% ± 35.3%). After adjusting the related factors in the linear regression model, generic prescribing ratios of suburban and rural clinics were significantly higher than those of urban clinics (β = 0.043 and 0.077; P = 0.024 and 0.008, resp.). The generic prescribing ratio of the most popular antihypertensive agents at a clinic was reversely associated with the urbanization level. PMID:24683364

Hard times and common mental health disorders in developing countries: insights from urban Ghana.

PubMed

Dzator, Janet

2013-01-01

Over the past century, the world has rapidly become urbanized, meaning more people now live in urban areas and cities than in rural areas. The mass movement of the rural poor to urban centers and cities has also changed the dynamics of poverty. Scarce employment opportunities, lack of assets, and sudden changes in economic conditions have been proposed as increasing the stress level for most urban residents, especially the poorer ones. Using a face-to-face household survey that included a six-item non-specific psychometric instrument, the data revealed how psychological distress may be patterned by socioeconomic status among urban residents in Ghana during difficult times characterized by food and fuel price hikes. The data collected in interviews of 1,158 adults (49% males and 51% females) who were 18 years and above were analyzed using multinomial logit regressions. The results confirmed previous findings and showed negative links between socioeconomic status, adverse life events, and psychological distress. Specifically, low income, low level of education, large household size, undesirable life events and being employed in agriculture was found to be associated with psychological disorders. The outcomes of this research project are consistent with previous findings-that people in lower socioeconomic strata and those who have suffered adverse events are more likely to suffer psychological distress. The implications of these results for behavioral health are discussed.

Comparing three approaches of evapotranspiration estimation in mixed urban vegetation; field-based, remote sensing-based and observational-based methods

USGS Publications Warehouse

Nouri, Hamideh; Glenn, Edward P.; Beecham, Simon; Chavoshi Boroujeni, Sattar; Sutton, Paul; Alaghmand, Sina; Nagler, Pamela L.; Noori, Behnaz

2016-01-01

Despite being the driest inhabited continent, Australia has one of the highest per capita water consumptions in the world. In addition, instead of having fit-for-purpose water supplies (using different qualities of water for different applications), highly treated drinking water is used for nearly all of Australia’s urban water supply needs, including landscape irrigation. The water requirement of urban landscapes, and particularly urban parklands, is of growing concern. The estimation of ET and subsequently plant water requirements in urban vegetation needs to consider the heterogeneity of plants, soils, water and climate characteristics. Accurate estimation of evapotranspiration (ET), which is the main component of a plant’s water requirement, in urban parks is highly desirable because this water maintains the health of green infrastructure and this in turn provides essential ecosystem services. This research contributes to a broader effort to establish sustainable irrigation practices within the Adelaide Parklands in Adelaide, South Australia.

The less healthy urban population: income-related health inequality in China.

PubMed

Yang, Wei; Kanavos, Panos

2012-09-18

Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. The study finds that the poor are less likely to report their health status as "excellent or good" and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality.

The less healthy urban population: income-related health inequality in China

PubMed Central

2012-01-01

Background Health inequality has been recognized as a problem all over the world. In China, the poor usually have less access to healthcare than the better-off, despite having higher levels of need. Since the proportion of the Chinese population living in urban areas increased tremendously with the urbanization movements, attention has been paid to the association between urban/rural residence and population health. It is important to understand the variation in health across income groups, and in particular to take into account the effects of urban/rural residence on the degree of income-related health inequalities. Methods This paper empirically assesses the magnitude of rural/urban disparities in income-related adult health status, i.e., self-assessed health (SAH) and physical activity limitation, using Concentration Indices. It then uses decomposition methods to unravel the causes of inequalities and their variations across urban and rural populations. Data from the China Health and Nutrition Survey (CHNS) 2006 are used. Results The study finds that the poor are less likely to report their health status as “excellent or good” and are more likely to have physical activity limitation. Such inequality is more pronounced for the urban population than for the rural population. Results from the decomposition analysis suggest that, for the urban population, 76.47 per cent to 79.07 per cent of inequalities are driven by non-demographic/socioeconomic-related factors, among which income, job status and educational level are the most important factors. For the rural population, 48.19 per cent to 77.78 per cent of inequalities are driven by non-demographic factors. Income and educational attainment appear to have a prominent influence on inequality. Conclusion The findings suggest that policy targeting the poor, especially the urban poor, is needed in order to reduce health inequality. PMID:22989200

Skewed Riskscapes and Gentrified Inequities: Environmental Exposure Disparities in Seattle, Washington

PubMed Central

White, Jonah

2011-01-01

Objectives. Few studies have considered the sociohistorical intersection of environmental injustice and gentrification; a gap addressed by this case study of Seattle, Washington. This study explored the advantages of integrating air toxic risk screening with gentrification research to enhance proximity and health equity analysis methodologies. It was hypothesized that Seattle's industrial air toxic exposure risk was unevenly dispersed, that gentrification stratified the city's neighborhoods, and that the inequities of both converged. Methods. Spatial characterizations of air toxic pollution risk exposures from 1990 to 2007 were combined with longitudinal cluster analysis of census block groups in Seattle, Washington, from 1990 to 2000. Results. A cluster of air toxic exposure inequality and socioeconomic inequity converged in 1 area of south central Seattle. Minority and working class residents were more concentrated in the same neighborhoods near Seattle's worst industrial pollution risks. Conclusions. Not all pollution was distributed equally in a dynamic urban landscape. Using techniques to examine skewed riskscapes and socioeconomic urban geographies provided a foundation for future research on the connections among environmental health hazard sources, socially vulnerable neighborhoods, and health inequity. PMID:21836115

Skewed riskscapes and gentrified inequities: environmental exposure disparities in Seattle, Washington.

PubMed

Abel, Troy D; White, Jonah

2011-12-01

Few studies have considered the sociohistorical intersection of environmental injustice and gentrification; a gap addressed by this case study of Seattle, Washington. This study explored the advantages of integrating air toxic risk screening with gentrification research to enhance proximity and health equity analysis methodologies. It was hypothesized that Seattle's industrial air toxic exposure risk was unevenly dispersed, that gentrification stratified the city's neighborhoods, and that the inequities of both converged. Spatial characterizations of air toxic pollution risk exposures from 1990 to 2007 were combined with longitudinal cluster analysis of census block groups in Seattle, Washington, from 1990 to 2000. A cluster of air toxic exposure inequality and socioeconomic inequity converged in 1 area of south central Seattle. Minority and working class residents were more concentrated in the same neighborhoods near Seattle's worst industrial pollution risks. Not all pollution was distributed equally in a dynamic urban landscape. Using techniques to examine skewed riskscapes and socioeconomic urban geographies provided a foundation for future research on the connections among environmental health hazard sources, socially vulnerable neighborhoods, and health inequity.

Reliability of perceived neighbourhood conditions and the effects of measurement error on self-rated health across urban and rural neighbourhoods.

PubMed

Pruitt, Sandi L; Jeffe, Donna B; Yan, Yan; Schootman, Mario

2012-04-01

Limited psychometric research has examined the reliability of self-reported measures of neighbourhood conditions, the effect of measurement error on associations between neighbourhood conditions and health, and potential differences in the reliabilities between neighbourhood strata (urban vs rural and low vs high poverty). We assessed overall and stratified reliability of self-reported perceived neighbourhood conditions using five scales (social and physical disorder, social control, social cohesion, fear) and four single items (multidimensional neighbouring). We also assessed measurement error-corrected associations of these conditions with self-rated health. Using random-digit dialling, 367 women without breast cancer (matched controls from a larger study) were interviewed twice, 2-3 weeks apart. Test-retest (intraclass correlation coefficients (ICC)/weighted κ) and internal consistency reliability (Cronbach's α) were assessed. Differences in reliability across neighbourhood strata were tested using bootstrap methods. Regression calibration corrected estimates for measurement error. All measures demonstrated satisfactory internal consistency (α ≥ 0.70) and either moderate (ICC/κ=0.41-0.60) or substantial (ICC/κ=0.61-0.80) test-retest reliability in the full sample. Internal consistency did not differ by neighbourhood strata. Test-retest reliability was significantly lower among rural (vs urban) residents for two scales (social control, physical disorder) and two multidimensional neighbouring items; test-retest reliability was higher for physical disorder and lower for one multidimensional neighbouring item among the high (vs low) poverty strata. After measurement error correction, the magnitude of associations between neighbourhood conditions and self-rated health were larger, particularly in the rural population. Research is needed to develop and test reliable measures of perceived neighbourhood conditions relevant to the health of rural populations.

Rural and urban married Asian immigrants in Taiwan: determinants of their physical and mental health.

PubMed

Chen, Walter; Shiao, Wen-Been; Lin, Blossom Yen-Ju; Lin, Cheng-Chieh

2013-12-01

Different geographical areas with unique social cultures or societies might influence immigrant health. This study examines whether health inequities and different social factors exist regarding the health of rural and urban married Asian immigrants. A survey was conducted on 419 rural and 582 urban married Asian immigrants in Taiwan in 2009. Whereas the descriptive results indicate a worse mental health status between rural and urban married Asian immigrants, rural married immigrants were as mentally healthy as urban ones when considering different social variables. An analysis of regional stratification found different social-determinant patterns on rural and urban married immigrants. Whereas social support is key for rural immigrant physical and mental health, acculturation (i.e., language proficiency), socioeconomics (i.e., working status), and family structure (the number of family members and children living in the family) are key to the mental health of urban married immigrants in addition to social support. This study verifies the key roles of social determinants on the subjective health of married Asian immigrants. Area-differential patterns on immigrant health might act as a reference for national authorities to (re)focus their attention toward more area-specific approaches for married Asian immigrants.

Review of the Literature: A Rural-Urban Comparison of Social Networks of Older Adults Living With HIV.

PubMed

Gannon, Brittany N; Stacciarini, Jeanne-Marie R

2016-01-01

Globally, aging populations and older persons living with HIV (OPLWH) are emerging socioeconomic and health care concerns. Aging adults living in rural communities have less access to and lower utilization of health care services; they rely heavily on available peer and family networks. Although social networks have been linked to positive mental and physical health outcomes, there is a lack of understanding about social networks in rural-dwelling OPLWH. The purpose of this integrative literature review was to compare emerging themes in the social network components of rural versus urban-dwelling OPLWH and network benefits and barriers. Overarching themes include: limited and/or fragile networks, social inclusion versus social isolation, social capital, and health outcomes. Results demonstrate an overall lack of rural-focused research on OPLWH and a universal lack of informal and formal networks due to isolation, lack of health care services, and omnipresent HIV stigma. Copyright © 2016 Association of Nurses in AIDS Care. Published by Elsevier Inc. All rights reserved.

Modeling the effects of LID practices on streams health at watershed scale

NASA Astrophysics Data System (ADS)

Shannak, S.; Jaber, F. H.

2013-12-01

Increasing impervious covers due to urbanization will lead to an increase in runoff volumes, and eventually increase flooding. Stream channels adjust by widening and eroding stream bank which would impact downstream property negatively (Chin and Gregory, 2001). Also, urban runoff drains in sediment bank areas in what's known as riparian zones and constricts stream channels (Walsh, 2009). Both physical and chemical factors associated with urbanization such as high peak flows and low water quality further stress aquatic life and contribute to overall biological condition of urban streams (Maxted et al., 1995). While LID practices have been mentioned and studied in literature for stormwater management, they have not been studied in respect to reducing potential impact on stream health. To evaluate the performance and the effectiveness of LID practices at a watershed scale, sustainable detention pond, bioretention, and permeable pavement will be modeled at watershed scale. These measures affect the storm peak flows and base flow patterns over long periods, and there is a need to characterize their effect on stream bank and bed erosion, and aquatic life. These measures will create a linkage between urban watershed development and stream conditions specifically biological health. The first phase of this study is to design and construct LID practices at the Texas A&M AgriLife Research and Extension Center-Dallas, TX to collect field data about the performance of these practices on a smaller scale. The second phase consists of simulating the performance of LID practices on a watershed scale. This simulation presents a long term model (23 years) using SWAT to evaluate the potential impacts of these practices on; potential stream bank and bed erosion, and potential impact on aquatic life in the Blunn Watershed located in Austin, TX. Sub-daily time step model simulations will be developed to simulate the effectiveness of the three LID practices with respect to reducing potential erosion from stream beds and banks by studying annual average excess shear and reducing potential impact on aquatic life by studying rapid changes and variation in flow regimes in urban streams. This study will contribute to develop a methodology that evaluates the impact of hydrological changes that occur due to urban development, on aquatic life, stream bank and bed erosion. This is an ongoing research project and results will be shared and discussed at the conference.

GENERATING HIGH QUALITY IMPERVIOUS COVER DATA

EPA Science Inventory

Nonpoint source pollution (NPS) from urban/ suburban areas is rapidly increasing as the population increases in the United States. Research in recent years has consistently shown a strong relationship between the percentage of impervious cover in a drainage basin and the health...

Orbivirus of livestock

USDA-ARS?s Scientific Manuscript database

The Arthropod Borne Animal Diseases Unit (ABADRU) mission is to solve major endemic, emerging, and exotic arthropod-borne disease problems in livestock. The ABADRU has four 5-year project plans under two ARS National Research Programs; Animal Health NP103 and Veterinary, Medical, and Urban Entomolog...

Implementing Community-based Health Planning and Services in impoverished urban communities: health workers' perspective.

PubMed

Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba

2018-03-20

Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been fraught with several opportunities to introduce innovations which tailor the rural milestones to meet urban needs. Modifications such as adjusting timing of home visits and renting accommodation in the communities for the CHOs have been beneficial to the programme.

Urbanization as a determinant of health: a socioepidemiological perspective.

PubMed

Patil, Rajan R

2014-01-01

Urbanization is a process that leads to the growth of cities due to industrialization and economic development and that leads to urban-specific changes. Urbanization is associated with profound changes in diet and exercise that in turn increase the prevalence of obesity with attendant increases in risk of type II diabetes and cardiovascular disease. The growing burden of disease among vulnerable populations and pervasive socioeconomic inequities within urban systems exaggerates the adverse impacts of urbanization on health. More than one half of children younger than age 5 of urban poor are stunted and/or underweight. More than one half of the child births occur at home, in slums, putting the life of the mother and newborn in serious risk. Inadequate reach of services due to illegality, social exclusion of slums, hidden slum pockets, and weak social fabric have resulted in a rapid proliferation of the unqualified private health sector, leading to high health expenditures and continuing a vicious cycle of poverty and ill health in urban slums.

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 Form, Health, and the Law’s Limits

PubMed Central

Buzbee, William W.

2003-01-01

Urban form, the law, and health are undoubtedly linked. However, nonlegal factors such as 20th-century reliance on the automobile as well as associated governmental actions and private investment choices have greatly influenced urban form, especially urban sprawl. The American system of federalism, with its traditional allocation of land-use legal authority to local governments, and resulting fragmented legal authority over causes and effects of urban sprawl, renders difficult legal efforts to reshape urban form. Legal frameworks and the dynamics and effects of urban sprawl are largely mismatched. Still, existing legal frameworks and modest legal reforms provide means to encourage or at least allow urban forms that are more conducive to health. However, the law will not easily transform urban form and deter urban sprawl. PMID:12948950

Investigating the Potential of Land Use Modifications to Mitigate the Respiratory Health Impacts of NO2: A Case Study in the Portland-Vancouver Metropolitan Area

NASA Astrophysics Data System (ADS)

Rao, Meenakshi

The health impacts of urban air pollution are a growing concern in our rapidly urbanizing world. Urban air pollutants show high intra-urban spatial variability linked to urban land use and land cover (LULC). This correlation of air pollutants with LULC is widely recognized; LULC data is an integral input into a wide range of models, especially land use regression models developed by epidemiologists to study the impact of air pollution on human health. Given the demonstrated links between LULC and urban air pollution, and between urban air pollution and health, an interesting question arises: what is the potential of LULC modifications to mitigate the health impacts of urban air pollution? In this dissertation we assess the potential of LULC modifications to mitigate the health impacts of NO2, a respiratory irritant and strong marker for combustion-related air pollution, in the Portland-Vancouver metropolitan area in northwestern USA. We begin by measuring summer and winter NO2 in the area using a spatially dense network of passive NO 2 samplers. We next develop an annual average model for NO2 based on the observational data, using random forest--for the first time in the realm of urban air pollution--to disentangle the effects of highly correlated LULC variables on ambient NO2 concentrations. We apply this random forest (LURF) model to a 200m spatial grid covering the study area, and use this 200m LURF model to quantify the effect of different urban land use categories on ambient concentrations of NO2. Using the changes in ambient NO2 concentrations resulting from land use modifications as input to BenMAP (a health benefits assessment tool form the US EPA), we assess the NO2-related health impact associated with each land use category and its modifications. We demonstrate how the LURF model can be used to assess the respiratory health benefits of competing land use modifications, including city-wide and local-scale mitigation strategies based on modifying tree canopy and vehicle miles traveled (VMT). Planting trees is a common land cover modification strategy undertaken by cities to reduce air pollution. Statistical models such as LUR and LURF demonstrate a correlation between tree cover and reduced air pollution, but they cannot demonstrate causation. Hence, we run the atmospheric chemistry and transport model CMAQ to examine to what extent the dry deposition mechanism can explain the reduction of NO2 which statistical models associate with tree canopy. Results from our research indicate that even though the Portland-Vancouver area is in compliance with the US EPA NO2 standards, ambient concentrations of NO2 still create an annual health burden of at least 40 million USD. Our model suggests that NO2 associated with high intensity development and VMT may be creating an annual health burden of 7 million and 3.3 million USD respectively. Existing tree canopy, on the other hand, is associated with an annual health benefit of 1.4 million USD. LULC modifications can mitigate some fraction of this health burden. A 2% increase in tree canopy across the study area may reduce incidence rates of asthma exacerbation by as much as 7%. We also find that increasing tree canopy is a more effective strategy than reducing VMT in terms of mitigating the health burden of NO 2. CMAQ indicates that the amount of NO2 removed by dry deposition is an order of magnitude smaller than that predicted by our statistical model. About one-third of the difference can be explained by the lower NO2 values predicted by CMAQ, and one-third may be attributable to parameterization of stomatal uptake.

Healthy Cities in a global and regional context.

PubMed

Lawrence, Roderick J; Fudge, Colin

2009-11-01

Since the beginning of the WHO European Healthy Cities Network in 1987, the global and regional contexts for the promotion of health and well-being have changed in many ways. First, in 2000, the United Nations Millennium Goals explicitly and implicitly addressed health promotion and prevention at the global and regional levels. Second, the concern for sustainable development at the Rio Conference in 1992 was confirmed at the World Summit in Johannesburg in 2002. During the same period, in many regions including Europe, the redefinition of the roles and responsibilities of national, regional and local governments, reductions in budgets of public administrations, the privatization of community and health services, the instability of world trade, the financial system and employment, migration flows, relatively high levels of unemployment (especially among youth and young adults) have occurred in many countries in tandem with negative impacts on specific policies and programmes that are meant to promote health. Since 1990, the European Commission has been explicitly concerned about the promotion of health, environment and social policies by defining strategic agendas for the urban environment, sustainable development and governance. However, empirical studies during the 1990s show that urban areas have relatively high levels of tuberculosis, respiratory and cardiovascular diseases, cancer, adult obesity, malnutrition, tobacco smoking, poor mental health, alcohol consumption and drug abuse, sexually transmitted diseases (including AIDS), crime, homicide, violence and accidental injury and death. In addition, there is evidence that urban populations in many industrialized countries are confronted with acute new health problems stemming from exposure to persistent organic pollutants, toxic substances in building structures, radioactive waste and increasing rates of food poisoning. These threats to public health indicate an urgent need for new strategic policies and research agendas that address the complex interrelations between urban ecosystems, sustainable development, human health and well-being. The WHO Healthy Cities project is one important vector for achieving this objective at both global and regional levels.

Environment, health, and gender in Latin America: trends and research issues.

PubMed

Wasserman, E

1999-04-01

Over the past several decades, Latin America underwent rapid urbanization, a demographic shift led by women. Women now make up almost half of the economically active population and the feminization of urban poverty is being reported as well. The majority of men and women now work in unregulated, unorganized "informal" and nontraditional industries and services lacking occupational and environmental regulations. There is a marked paucity of health studies examining possible hazardous exposures, especially where gender-based social etiologies are concerned. This is true even in concentrated industries such as manufacturing assembly plants and in potentially hazardous occupations in mining and nontraditional agricultural exports, for which data from other disciplines are available and raise serious concerns. The need to ensure enough jobs at sufficient levels of income to alleviate poverty will remain a major challenge at the turn of the century and the environmental health implications of doing so could be far-reaching. What data are available and, more strikingly, the paucity of published epidemiologic studies warrant deep concern and support calls for urgent, multidisciplinary research into the health effects of the combined, multiple assaults of hazardous industrial waste, inadequate water and sewage treatment, and occupational exposures. Given the complex and varied work roles of women, the information reviewed also points to the need to conduct such research in the region within a social-etiologic framework of gender analysis. Copyright 1999 Academic Press.

Use of technology with health care providers: perspectives from urban youth.

PubMed

Lindstrom Johnson, Sarah; Tandon, S Darius; Trent, Maria; Jones, Vanya; Cheng, Tina L

2012-06-01

To evaluate urban youths' use of and access to technology and solicit their opinions about using technology with healthcare providers. Urban youth (aged 14-24 years) were invited to participate in focus groups in which a trained focus group facilitator used a survey and a structured guide to elicit responses regarding the foregoing objective. All sessions were audiotaped and transcribed. Emergent themes were determined with the assistance of Atlas TI. Survey data were analyzed in SPSS (SPSS Inc, Chicago, Illinois). Eight focus groups including 82 primarily low-income urban African-American adolescents and young adults (mean age, 18.5 years) were completed. The participants reported fairly high access to and use of technology. However, they expressed some concerns regarding the use of technology with healthcare providers. Many worried about the confidentiality of conversations conducted using technology. Face-to-face meetings with a healthcare provider were preferred by most participants, who felt that the information provided would be better tailored to their individual needs and more credible. Although urban youth were high users of technology, they expressed reservations about using technology with health care providers. When developing new technology communication and information dissemination strategies, it is critical to understand and address these concerns while involving young people in the research and development process. Copyright © 2012 Mosby, Inc. All rights reserved.