Journal of Urban Health最新文献

Chronic insufficient and poor-quality sleep are linked to hypertension, diabetes, depression, heart attack, and stroke. While studies on substance use and sleep typically focus on people in or entering treatment, there is a lack of research on sleep health among community-recruited people who inject drugs (PWID). To address this literature gap, we examined factors associated with insufficient and poor-quality sleep among community-recruited PWID. We recruited and interviewed 472 active opioid-using PWID (injected within the last 30 days) in Los Angeles, CA and Denver, CO between 2021 and 2022. Participants completed computer-assisted interviews covering demographics, subsistence measures, drug use patterns, injection-related behaviors, health risks, and sleep duration and quality in the last 3 months. Descriptive statistics were used to analyze all variables for subjects with complete responses to sleep items (n = 464). Bivariate analyses determined factors associated with sleep measures using chi-square and t-tests. Collinear variables were removed, and binomial linear multivariable regression calculated risk ratios (RR) for insufficient and poor-quality sleep in the last 3 months. Participants exhibited low sleep duration (mean = 4.99, standard deviation (SD) = 2.70), with 76% reporting insufficient sleep and 62% poor-quality sleep. Bivariate analyses associated both sleep measures with drug use, high subsistence scores, violent victimization, and poor health outcomes. Multivariable analyses showed a high subsistence score predicting insufficient (RR = 1.31) and poor-quality sleep (RR = 1.69) compared to low subsistence. Poor sleep health is common among structurally vulnerable community-recruited PWID, as measured by subsistence index associated with adverse sleep outcomes. Further research on structural interventions to address sleep and subsequent health outcomes among PWID is imperative.

Reliable electricity, elevators, heat, hot water, and water are aspects of safe and accessible housing. Interruptions to these services represent a persistent challenge faced by public housing residents in the New York City Housing Authority (NYCHA). We compiled outage data spanning 2020–2022 from NYCHA’s online service interruptions portal and paired these data with demographic and meteorological sources to understand the burden of these outages. To ease dissemination of these data—a spatiotemporally granular outage dataset that could fill gaps surrounding urban outage health impacts—we provide a public dashboard for visualization and download of the service interruption data in an analysis-ready format. We demonstrated that (1) outages often exceeded health-relevant restoration windows (e.g., 8 h for electrical interruptions); (2) senior developments (exclusively residents 62 +) had the longest duration of elevator, heat, and hot water outages; and (3) outages sometimes overlapped with temperature extremes—potentially increasing their health risk. Residents of NYCHA, who are predominately low-income, Black, and Hispanic face a disproportionate burden of service interruptions. Like all New Yorkers, NYCHA residents deserve to live in dignified housing that is safe and accessible. Addressing service interruptions are one way to make public housing safer and push toward climate and environmental justice.

The USA has some of the highest utilization rates of the Emergency Department (ED) worldwide, leading to increased healthcare costs, constrained resources, and fragmented care. Many of the highest ED utilizers are persons experiencing homelessness (PEH) and those with mental health conditions, with even higher use by those with comorbid social challenges. This study reviewed the literature assessing interventional approaches in the ED to minimize the burden of ED utilization by PEH with associated mental health conditions. We first conducted an informal literature review of high ED utilizers and their most common presenting symptoms. We then conducted a scoping review of articles according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines; we used PubMed and Web of Science databases as well as Google Scholar. We screened the titles and abstracts of studies that evaluated programs that aimed to reduce ED usage by patients with mental illness who were also experiencing homelessness. Of the 1574 titles and abstracts screened, 49 full texts were examined for eligibility. Of those, 35 articles were excluded for a final count of 14 included studies. We found that the studies fell under two main interventional categories: housing support and care management. There were various approaches to reduce ED visits from PEH with mental illness around the world. Overall, these studies found varying degrees of success in reducing ED visits for both housing intervention and care management strategies. Comparison of these studies reveals that the success of related strategies like housing support often have different outcomes which can be attributed to the differences between the populations studied, previously available community resources, and other psychosocial factors affecting study participants. Overall, the most successful studies found that a tailored approach that addresses the unique needs of participants had the greatest impact on reducing ED visits and hospitalizations. Further research is needed to determine the best strategies for specific populations and how to promote health equity among PEH with associated mental health conditions.

Neighborhood safety is crucial for the well-being of residents; however, longitudinal evidence is scarce. This study explored the association between neighborhood safety concerns and depressive symptoms among women. A nationally representative sample of 10,008 women was surveyed in 2016. Six dimensions of neighborhood safety concerns were assessed: crime, food, safety at night, traffic accidents, building and facility, and general safety. The total score for neighborhood safety concerns ranged from 6 to 24, with higher scores indicating greater concerns. Depressive symptoms were assessed using the 10-item version of the Center for Epidemiologic Studies Depression. For cross-sectional analyses, we explored how neighborhood safety concerns were associated with concurrent depressive symptoms at baseline. For the longitudinal analyses, we explored how they were associated with depressive symptom onset at the 2-year follow-up (2018) among women without depressive symptoms at baseline (n = 7,643). Logistic regressions were employed. The mean (standard deviation [SD]) of the neighborhood safety concern score was 12.7 (3.3). In the cross-sectional analysis, a 1-SD increase in neighborhood safety concern score was associated with 1.23-fold (95% CI: 1.13–1.35) increase in the odds of concurrent depressive symptoms at the baseline year. In the longitudinal analysis, a 1-SD increase in neighborhood safety concern score was associated with 1.15-fold (95% CI: 1.03–1.29) increase in the odds of experiencing the onset of depressive symptoms at the follow-up year. This study suggests that neighborhood safety concerns are risk factors for the development of depressive symptoms of female residents. Policy efforts are necessary to ensure community safety.

Many aging mid-twentieth-century social housing developments worldwide are set to undergo major redevelopment, aiming to improve residents’ living conditions. Nevertheless, the associated processes, particularly the challenges of relocation during the demolition and reconstruction phase, can significantly disrupt communities and social networks. Understanding the multifaceted impacts of social housing redevelopment projects is crucial to inform planning, design, and consultation for these projects. This scoping literature review explores how residents’ health and well-being are considered in the process of social housing redevelopment. We identified eight studies through a search performed on EMBASE, PubMed, and Scopus databases, with an additional hand search of the bibliographies of selected studies. A thematic analysis was conducted to identify the health and well-being impacts of the different phases during redevelopment projects. The findings demonstrate that social housing redevelopment projects have varied impacts on residents’ health and well-being depending on the subgroup of residents and the contextual characteristics of the original social housing estate. While improved physical infrastructure provides opportunities for better health outcomes, the disruption and lack of control during the relocation process may cause significant adverse health impacts. Moreover, the different phases during the redevelopment process expose different subgroups to varying risks. Based on these findings, we recommend that social housing redevelopment initiatives prioritize engaging and empowering residents to have better control in decision-making throughout all phases of the redevelopment.

The COVID-19 pandemic highlighted the importance of addressing social needs in a crisis context. Some US jurisdictions integrated a social service component into case investigation and contact tracing (CI/CT) programs, including the New York City (NYC) Test & Trace (T2) Program; the Take Care initiative referred NYC residents who tested positive or were exposed to COVID-19 to services to support isolation and quarantine and meet basic needs. More research is needed to determine effective implementation strategies for integrating social needs provision into CI/CT programs. To identify barriers and facilitators to the implementation of the Take Care initiative, we conducted key informant interviews with program staff, community-based organization partners, and cases and contacts as part of a larger evaluation of the T2 program. Interviews were recorded, transcribed, and analyzed using rapid qualitative methods. Key facilitators to implementation included utilizing a case management software system, employing strategies to encourage service uptake, leveraging cross-agency collaborations, and partnering with community-based organizations for resource navigation. Barriers identified included external management of the software system, challenges reaching and engaging the public, administrative complications due to shifting collaborations, and management of CBO partners’ structure and hiring. Based on our findings, we provide recommendations to support effective planning and implementation of social needs service provision in a crisis context. Future research should focus on testing promising implementation strategies highlighted in this study and applying them to varied contexts and crisis situations.

The relationship between racial/ethnic residential segregation and physical activity (PA) remains unclear with both positive and negative associations between segregation and PA recently reported. We aimed to examine the relationship between county-level residential segregation and total daily PA and domain-specific PA and whether these associations varied by gender. Participants (N = 2625, mean age [SD] = 45.2 [15.4]) were recruited from the AmeriSpeak panel who completed up to two Activities Completed over Time in 24 Hours (ACT24) previous day recalls in 2019. PA outcomes were created for the following: (1) light PA (LPA), (2) moderate-to-vigorous PA (MVPA), (3) total active time, and (4) domain-specific PA, including leisure, work, household, transport, personal, and other activities. County-level residential segregation based on isolation. Weighted generalized linear models were used to examine the relationship between county-level segregation and each PA outcome, controlling for age, gender, race/ethnicity, income, employment, body mass index, county-level poverty, and census region. Overall, results showed no association between county-level residential segregation and LPA, MVPA, total active time, and domain-specific PA among NH Black and Hispanic populations. Among NH Black females, greater residential segregation was associated with more total hours/day of activity (β = 3.54, 95% CI [0.23, 6.85]). Only NH Black females living in segregated neighborhoods had more total active time. Additionally, it is important to acknowledge that these relationships may vary among NH Black and Hispanic populations. Future studies should examine the interaction between segregation and a broader range of individual, contextual, and environmental factors in relation to PA and domain-specific PA.

Understanding how urban environments shape physical activity is critical in rapidly urbanizing countries such as South Africa. We assessed the reliability of virtual audits for characterizing urban features related to physical activity in Soweto, South Africa. We used the Microscale Audit of Pedestrian Streetscapes Global tool to characterize pedestrian-related features from Google Street View images in four neighborhoods of Soweto. Neighborhoods were selected to represent different levels of deprivation. Inter-rater reliability was analyzed according to the rater’s familiarity with the local area. The results show a higher inter-rater reliability was observed among auditors with greater contextual familiarity. Many measurements however generated inconclusive results due to either low variability in the raters’ responses or the absence of the features in the streets. It is evident from our findings that virtual audits are efficient tools that can be used to assess the built environment. However, to ensure meaningful use of these tools in diverse settings, we recommend that auditors comprise of people with contextual familiarity.

U.S. Immigration and Customs Enforcement (ICE) issues detainer requests to local law enforcement agencies to hold detainees suspected of being undocumented immigrants until they can be transferred into ICE custody. We examined the association between area-level detainer requests and self-rated health among Latine adults. We linked health data from Latine adults included in the 2017–2020 Behavioral Risk Factor Surveillance System (n = 69,386) to detainer requests per 1,000 non-citizens in core-based statistical areas, (n = 152 across 49 states). We fit logistic regression models of self-rated fair/poor health on detainer requests, adjusted for individual- and area-level confounders. In adjusted analyses, we found that Latine adults living in areas with the highest quartile of requests had 24% higher odds of fair/poor health (OR 1.24, 95% CI = 1.05,1.47) relative to those in the lowest quartile. Local law enforcement agencies should limit cooperation with federal immigrant agencies to protect the health of Latine communities.

Our objective was to determine whether Child Opportunity Index (COI), a measure of neighborhood socioeconomic and built environment specific to children, mediated the relationship of census tract Black or Hispanic predominance with increased rates of census tract violence-related mortality. The hypothesis was that COI would partially mediate the relationship. This cross-sectional study combined data from the American Community Survey 5-year estimates, the COI 2.0, and the Illinois Violent Death Reporting System 2015–2019 for the City of Chicago. Individuals ages 0–19 years were included. The primary exposure was census tract Black, Hispanic, White, and other race predominance (> 50% of population). The primary outcome was census tract violence-related mortality. A mediation analysis was performed to evaluate the role of COI as a potential mediator. Multivariable logistic regression modeling census tract violence-related mortality demonstrated a direct effect of census tract Black predominance (adjusted odds ratio [aOR] 2.59, 95% confidence interval [CI] 1.30–5.14) on violence-related mortality compared to White predominance. There was no association of census tract Hispanic predominance with violence-related mortality compared to White predominance (aOR 1.57, 95% CI 0.88–2.84). Approximately 64.9% (95% CI 60.2–80.0%) of the effect of census tract Black predominance and 67.9% (95% CI 61.2–200%) of the effect of census tract Hispanic predominance on violence-related mortality was indirect via COI. COI partially mediated the effect of census tract Black and Hispanic predominance on census tract violence-related mortality. Interventions that target neighborhood social and economic factors should be considered to reduce violence-related mortality among children and adolescents.