Journal of Urban Health-Bulletin of the New York Academy of Medicine最新文献

Despite increasing interest in the role of parks on children's health, there has been little empirical research on the impact of park interventions. We used a quasi-experimental pre-post study design with matched controls to evaluate the effects of park redesign and renovation on children's health-related quality of life (QoL) in underserved neighborhoods in New York City, with predominantly Hispanic and Black populations. Utilizing longitudinal data from the Physical Activity and Redesigned Community Spaces (PARCS) Study, we examined the parent-reported health-related QoL of 201 children aged 3-11 years living within a 0.3-mile radius of 13 renovated parks compared to 197 children living near 11 control parks before and after the park intervention. Health-related QoL was measured using a modified version of the KINDL questionnaire that assessed children's physical and emotional well-being, self-esteem, and well-being in home, peer, and school functioning. Linear mixed regression model was used to examine the difference in difference (DID) between the intervention vs. control group for QoL. We found a significant differential improvement in the physical well-being subscale of KINDL in the intervention vs. control group (DID = 6.35, 95% confidence interval [CI] = 0.85-11.85, p = 0.024). The effect was particularly strong among girls (DID = 7.88, p = 0.023) and children of the lowest socio-economic background (p < 0.05). No significant DID was found in other KINDL domains. Our study indicated a beneficial impact of improving park quality on the physical well-being of children residing in underserved neighborhoods. These findings lend support for investments in neighborhood parks to advance health equity.

Community violence is a major cause of injury and death in the USA. Empirical studies have identified that some place-based interventions of urban private places, such as remediations of vacant lots and buildings, are associated with reductions in community violence in surrounding areas. The aim of this study was to examine whether routine maintenance and repair of urban public places (e.g., street construction projects) are also associated with reductions in community violence, proxied by violent crime incidents. This staggered adoption difference-in-difference analysis investigated the association between street construction projects and community violence in New York City from 2010 to 2019, divided into 40 calendar quarters. The units of analysis were street-quarters (n = 155,280). Intervention street-quarters were those with completed projects in 2010-2019; control streets were those where projects were scheduled but not completed before 2019. The outcome of community violence was proxied by counts of crime and violence incidents reported to the New York Police Department, within street-quarters. There were 81,904 street-quarters with any community violence incidents (52.7%). We found that street construction projects were associated with a decrease in reckless endangerment (ATT = - 1.3%; 95% CI = - 2.1%, - 0.4%), robbery (ATT = - 3.4%; 95% CI = - 6.1%, - 0.7%), and weapons offenses (ATT = - 1.6%; 95% CI = - 3.0, - 0.08%) occurring on street-quarters. Street construction projects may be yet another type of place-based intervention to reduce community violence.

Understanding when and where heat adversely influences health outcomes is critical for targeting interventions and adaptations. However, few studies have analyzed the role of indoor heat exposures on acute health outcomes. To address this research gap, the study partnered with the New York City Fire Department Emergency Medical Services. Paramedics carried portable sensors that passively measured indoor temperatures at 3-min intervals while responding to calls during summer, 2016. Patient care reports provided the patient's chief health complaint and sociodemographic and health status information. Propensity score matching increased comparability between groups exposed to elevated indoor temperature versus those unexposed. To assess indoor heat-health associations, we conducted independent case-control studies between indoor heat exposures and cardiovascular (n = 735) and respiratory (n = 296) emergency medical calls when compared to heat-insensitive controls (n = 1611). Patients experiencing heat exposures (indoor temperature ≥ 28 °C) were not significantly more likely (OR, 1.15; 95% CI, 0.64-2.09) to receive care for respiratory conditions. Both outdoor and indoor temperatures increased the odds of receiving care for cardiovascular versus comparison calls. Outdoor temperatures consistently elevated cardiovascular risks (OR, 1.12; 95% CI, 1.05-1.19). There was some evidence that indoor temperatures further increased the odds of cardiovascular distress (OR, 1.44; 95% CI, 0.97-2.13). Sensitivity testing suggested indoor temperatures at a lower threshold (≥ 26 °C) were unrelated to either health outcome. Along with converging lines of evidence linking extreme heat to adverse cardiovascular outcomes, we present one of the first indoor heat observational studies.

Rapid urbanization and escalating climate crises place cities at the critical juncture of environmental and public health action. Urban areas are home to more than half of the global population, contributing ~ 75% of global greenhouse gas emissions. Structured surveys were completed by 191 leaders in city governments and civil society from 118 cities in 52 countries (February-April 2024). Data aggregated to report one response per city. The survey utilized framework and indicators established by The 2023 Lancet Countdown on Health and Climate Change. (1) Health hazards, exposures, impacts: two-thirds of cities identify extreme heat, flooding, and air pollution of "high concern," with health impacts for residents. (2) Adaptation, planning, resilience for health: Although 60% of cities have climate resilience plans, only 22.9% of cities have plans that concurrently address climate and health. Essential resources, municipal systems, and cross-sector collaborations are limited. (3) Mitigation actions and health co-benefits: 90% of cities reported air pollution from multiple sources; only 38% monitor air quality. Energy, food, and transportation systems are sub-optimal to mitigate climate concerns. (4) Economics and finance: 92% of cities report climate change-related economic losses; they plan to increase investments though resources remain constrained. (5) Public and political engagement: City leaders report minimal knowledge sharing among media, national/local government, scientific community, business community, and residents. Results underscore urgency for action and highlight solutions, providing a roadmap for cities to enhance resilience, safeguard public health, and promote social equity.

Environmental noise pollution is one of the biggest concerns and the most important challenges in urban areas. Evidence from epidemiological studies shows that acoustic pollution can impact human health, and the effects may be stronger in susceptible and sensitive individuals. The objective of the study was to determine the individual exposure to road transport noise for preschool children in the residential environment and to assess its impact on children's psychological health. This is the first representative large-scale noise impact study in Lithuania aimed at the psychological health of children. A total of 1457 parent-child pairs were involved in the study. Residential exposure to environmental noise caused by road transport in Kaunas agglomeration, Lithuania was determined by applying geographic information systems and strategic noise mapping. A standardized Strengths and Difficulties Questionnaire (SDQ) was used to assess psychological health problems in children. Multivariate logistic regression analysis was used to determine the association between residential exposure to environmental noise caused by road transport and children's psychological health. The results of the study showed that the risk of hyperactivity and total scale difficulties increased statistically significantly up to 77% and up to 48%, respectively, in the highest noise (L_night ≥ 50 dB) exposure. The obtained results provide new knowledge about the relationship between road traffic noise in the residential environment and the psychological health of preschool children.

This study investigates the relationship between home mortgages and neighborhood mental health across the 18 largest metropolitan statistical areas (MSAs) in the United States. Home mortgages, a primary avenue to homeownership, contribute to housing security and stability. Moreover, their issuance reflects local investment and potential improvements in the built environment, hypothesized to positively influence community mental well-being. Using census tract-level data from multiple sources, we employed a spatial econometric approach, specifically spatial error modeling, to account for spatial dependency and estimate the association between home mortgage lending (2011 to 2020) and the prevalence of self-reported poor mental health in 2020. Our findings indicate a statistically significant negative association between mortgage issuance and self-reported poor mental health across all 18 MSAs, suggesting that increased mortgage lending is associated with improved neighborhood mental health. Comparisons between standard linear models and spatial error models highlight the influence of unmeasured, spatially correlated factors on neighborhood mental health outcomes. This study underscores mortgage lending as a crucial factor in community well-being and emphasizes the necessity of addressing spatial dependency in neighborhood health studies for accurate estimations. The findings offer valuable insights for researchers and policymakers aiming to enhance community mental health and address health disparities through informed housing policies.

Environmental noise is a significant public health concern, ranking among the top environmental risks to citizens' health and quality of life. Despite extensive research on atmospheric pollution's impact on mental health, spatial studies on noise pollution effects are lacking. This study fills this gap by exploring the association between noise pollution and depression in England, with a focus on localised patterns based on area deprivation. Depression prevalence, defined as the percentage of patients with a recorded depression diagnosis, was calculated for small areas within Cheshire and Merseyside ICS using the Quality and Outcomes Framework Indicators dataset for 2019. Strategic noise mapping for rail and road noise (Lden) was used to measure 24-h annual average noise levels, with adjustments for evening and night periods. The English Index of Multiple Deprivation (IMD) was employed to represent neighborhood deprivation. Geographically weighted regression and generalised structural equation spatial modeling (GSESM) assessed the relationships between transportation noise, depression prevalence, and IMD at the Lower Super Output Area level. The study found that while transportation noise had a low direct effect on depression levels, it significantly mediated other factors associated with depression. Notably, GSESM showed that health deprivation and disability were strongly linked (0.62) to depression through the indirect effect of noise, especially where transportation noise exceeds 55 dB on a 24-h basis. Understanding these variations is crucial for developing noise mitigation strategies. This research offers new insights into noise, deprivation, and mental health, supporting targeted interventions to improve quality of life and address health inequalities.

Depression and post-traumatic stress disorder (PTSD) are serious consequences of physical injuries. Stress associated with living in urban neighborhoods with socioecological disadvantages and the cumulative burdens of adverse childhood experiences (ACEs) can lead to poorer psychological outcomes. Limited research has explored how ACEs and socioecological environmental exposures in childhood and adulthood, together, impact post-injury outcomes. This study assessed the relative contributions of ACEs and neighborhood exposures during childhood and adulthood on post-injury outcomes among Black men in Philadelphia. We used data from a prospective cohort of 414 Black men from the Philadelphia region, aged ≥ 18 years, who sustained acute physical injuries requiring hospitalization. Primary outcomes were post-injury PTSD and depression. Secondary outcomes were sleep quality, self-reported health status, changes in substance use, and return to work. The study used perceived and objective measures of neighborhood characteristics and self-reported ACEs to model their relative impact on outcomes 3 months after hospital discharge. Higher levels of ACEs and higher perceived neighborhood disorder during childhood and adulthood were significant predictors of PTSD and depression symptom severity. Perceived neighborhood disorder contributed to sleep disturbances and decline in post-injury health. Census/administrative objective measures of neighborhood disadvantage did not show consistent associations with post-injury outcomes. Findings suggest that both ACEs and subjective perception of neighborhood environments are critical factors influencing post-injury recovery in urban Black men. Interventions to improve post-injury outcomes should consider preventing ACEs and addressing the tangible conditions of neighborhoods and residents' perceptions of their surroundings to promote health equity and injury recovery.

Environmental context is an important predictor of health behavior. Understanding its effect on cannabis use among pregnant women is yet to be understood. The aim of the study is to assess the impact of perceived neighborhood environment on prenatal cannabis use and explore the mediating role of stress. Data are from the Life-Course Influences on Fetal Environments Study (LIFE), a retrospective cohort of postpartum African American women in Metropolitan Detroit, Michigan (2009-2011). Prenatal cannabis use was defined as self-reported ever use during pregnancy. Three perceived neighborhood scales were considered: social cohesion and trust, social disorder, and danger and safety. Out of 1,369 women, 151 (11.0%) self-reported using cannabis during pregnancy. After adjusting for age, marital status, income, years of education, and general social support scale, the odds of cannabis use significantly increased among the lowest quartiles of all the neighborhood scales suggesting higher cannabis use among women who perceived their neighborhoods to have the worst conditions. Compared to the highest quartile, the odds ratio (OR) for the lowest quartiles for social cohesion and trust, social disorder, and danger and safety were 1.77 (95% confidence interval (CI): 1.04-3.03), 1.83 (95% CI: 1.15-2.91), and 1.93 (95% CI: 1.12-3.31) respectively. Evidence of mediation by perceived stress was only present between the association of perceived levels of safety and danger with cannabis use during pregnancy. Future prospective studies are warranted to understand the causal associations between individual correlates and social and physical environmental factors of prenatal cannabis use.

Historical redlining, a racially discriminatory practice implemented by the US government in the 1930s, has been associated with present-day environmental outcomes. However, there is limited research examining the relationship between historical redlining and contemporary housing quality. The objective of the present study was to investigate the relationship between historical redlining and contemporary housing quality in Atlanta, Georgia. Spatial patterns of housing code violation complaints from 2015 to 2019 were examined using point-pattern and spatial cluster analyses. We used Bayesian hierarchical models, accounting for spatial autocorrelation, to estimate associations between historical redlining and housing complaints, after adjusting for contemporary neighborhood characteristics, such as poverty, median structure age, vacant and renter-occupied properties, and residential racial segregation. A total of 48,626 housing code violation complaints were reported during the study period, including 6531 complaints deemed "hazardous." Historical redlining was a statistically significant predictor of housing complaints. We observed a 167% increased risk (IRR = 2.67, 95% confidence interval = 1.49, 4.77) of housing complaints for historically redlined neighborhoods compared to neighborhoods historically graded as "best" or "still desirable," after adjusting for neighborhood characteristics. Redlined neighborhoods also had an increased risk of "hazardous" housing complaints (IRR = 1.94, 95% confidence interval = 1.11, 3.40), after adjusting for contemporary neighborhood characteristics. Historically redlined neighborhoods exhibited disproportionately higher rates of housing code violation complaints. Spatial analysis of housing code violation complaints can provide insights into housing quality and inform interventions targeted at addressing the environmental legacy of structural racism.