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

Parks are one component of the built environment to promote regular physical activity (PA) among youth. This study investigated differences in park-based PA among youth based on demographics and park features in racially or ethnically diverse communities. In 2017-2018, parks were selected in majority Asian (n = 3), Latino (n = 5), and Black (n = 4) neighborhoods in North Carolina (n = 6) and New York (n = 6). Researchers recruited parents/caregivers of 5-10-year-olds to participate. Children wore an Actigraph GT3 + waist accelerometer and a QStarz GPS unit and were instructed to play normally for at least 15 min. Evenson cut-points were used to classify PA levels as sedentary, light, moderate, and vigorous. Chi-squared tests and non-parametric Kruskal-Wallis tests were used to examine differences in PA intensity minutes (sedentary, light, moderate-to-vigorous) across study location and demographic variables. Youth participated from NY (n = 200) and NC (n = 157). Overall, most park-based PA was spent in light intensity (59.9%), followed by moderate-to-vigorous intensity (32.4%). Females, compared to male participants, spent more time in sedentary behavior (9.0%, 6.1%) and less time in moderate-to-vigorous PA (26.6%, 38.1%). Participants who identified as Black (32.9% MVPA), Latino (35.8%), and Other (39.8%) spent higher percentages of time in moderate-to-vigorous PA than Asian (26.6%) and non-Hispanic White (21.3%) participants. The highest proportion of moderate-to-vigorous PA occurred on swing sets (46%) and basketball courts (45%). Racial and ethnic, sex, and activity area differences in park-based PA indicate that diverse youth use parks uniquely; these factors should be considered in designing parks for various ages and backgrounds.

The WHO emphasizes the importance of taking area-level factors into account when formulating public health interventions. The aim of this systematic review was to identify which area-level factors are associated with children's dental caries in Europe and might therefore be a suitable starting point for public health interventions. We conducted a systematic review based on a search in PubMed, Web of Science, and Cochrane Library including all European studies on caries in children and their area-level factors published since the year 2000 in English or German. We included 39 studies and identified 13 area-level factors investigated in the literature: degree of urbanization, deprivation, mean housing price, gross-national product, mean level of education, unemployment proportion and income, density of supermarkets, snack bars and dental offices, health, diet, and crime. Rural residency and higher unemployment were weakly associated with poorer oral health regarding dental caries. Deprivation showed a stronger (inverse) association. For income, findings were ambiguous; studies showed associations in both directions. For the other determinants, the included studies found no association. Many studies reported associations between place of residence and children's dental caries, but the mediators on this causal path are still not clearly established. The area-level factors analyzed in this review seem to play a role, but more studies with designs that allow causal interpretation of findings are needed to establish solid robust evidence that can be used in the formulation of future health policies.

Rates of family violence, including intimate partner violence (IPV) and child maltreatment, remain high in the USA and contribute to substantial health and economic costs. How neighborhood environment may influence family violence remains poorly understood. We examine the association between neighborhood vacant and abandoned properties and family violence, and the role collective efficacy may play in that relationship. Data were used from a longitudinal cohort of 218 maternal-child dyads in a southern US city known for elevated rates of violence. Women were matched on their propensity score, for living in a neighborhood with elevated vacant and cited properties. Analyses accounting for clustering in neighborhood and matched groups were conducted to examine the association between neighborhood vacant and abandoned property and family violence and the potential mediating relationship of collective efficacy. The likelihood of experiencing child maltreatment at 12 months of age was more than twice as high for children living in neighborhoods with high vacant and cited property rates compared with women living in neighborhoods with fewer vacant and cited properties (OR = 2.11, 95% CI = 1.03, 4.31). Women living in neighborhoods characterized by high levels of vacant and cited properties were also more than twice as likely to report IPV (OR = 2.52, 95% CI = 1.21, 5.25). Associations remained mostly stable after controlling for key covariates. Collective efficacy did not act as a mediator in the relationship between vacant and cited properties and family violence. Reducing neighborhood vacant and cited properties may be an important target for interventions focused on reducing family violence.

Using 2022 data from 600 adults (≥ 60 years) in Porto, Portugal, we explored the association between housing insecurity and various health outcomes. We examined housing conditions, affordability, and stability in relation to loneliness, quality of life, cognitive function, perception of healthy ageing, and sleep using regression models. Older adults without house heating (β = 2.293; 95%CI = 0.753, 3.833), with leaks/dampness/rot (β = 3.741; 1.818, 5.664), insufficient daylight (β = 2.787; 0.095, 5.479), living in neighborhoods with noise (β = 1.793, 0.280 to 3.305), pollution/grime (β = 2.580; 0.746, 4.414), and violence/crime/vandalism (β = 3.940; 1.723, 6.157), who faced housing cost overburden (β = 2.001; 0.426, 3.577), eviction (β = 12.651; 0.852, 24.450), and moved frequently (β = 4.129; 1.542, 6.716) exhibited higher levels of loneliness. Similarly, lack of house heating (β = - 1.942; - 3.438, - 0.445), leaks/dampness/rot (β = - 4.157; - 5.999, - 2.316), insufficient daylight (β = - 3.124; - 5.714, - 0.534), noise (β = - 2.143; - 3.600, - 0.686), pollution/grime (β = - 2.093; - 3.860, - 0.325), violence/crime/vandalism (β = - 2.819; - 4.948, - 0.691), and those with housing cost overburden (β = - 2.435; - 3.930, - 0.940) reported lower quality of life. Those with no toilet (β =  - 1.891; - 3.760, - 0.021) or shower (β =  - 1.891; - 3.760, - 0.021) and who faced forced displacement (β =  - 2.179; - 3.516, - 0.842) presented lower cognitive function. Furthermore, those living in neighborhoods with pollution/grime (OR = 0.494; 0.322, 0.756) and violence/crime/vandalism (OR = 0.477; 0.284, 0.801), those in social housing (OR = 0.728; 0.575, 0.922), and those who moved frequently (OR = 0.475; 0.257, 0.879) reported lower levels of perceived healthy ageing. Insufficient sleep was more common among residents in social housing (OR = 2.155; 1.102, 4.213), while poor sleep quality was least likely both among those living in social housing (OR = 0.445; 0.220, 0.900) and affordable housing (OR = 0.381; 0.162, 0.896). Good quality, stable, and affordable housing seems crucial for healthy ageing.

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.