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

Gayborhoods are urban neighborhoods characterized by a high concentration of LGBTQ + residents, businesses, community spaces, and subcultures. Living in gayborhoods may foster a sense of community and belonging that can be particularly beneficial for sexual minority men. However, existing research on gayborhoods has predominantly centered on the experiences of White gay men. The extent to which gayborhoods serve as an inclusive space for ethnically diverse sexual minority men remains largely unexplored. This paper examines the associations of gayborhood residence with LGBTQ + community connectedness, psychological distress, and substance use among ethnically diverse sexual minority men. Utilizing data from the 2023 Gay Asian Men Survey, this paper included 1071 cisgender sexual minority men of Asian backgrounds in Australia. The results indicated that older, middle-class, and gay men were more likely to live in gayborhoods than their younger, lower-class, and bisexual counterparts. The mediation analysis revealed the coexistence of positive and negative impacts of living in gayborhoods. Specifically, gayborhood residence was positively associated with LGBTQ + community connectedness, which was in turn associated with reduced levels of psychological distress but heightened levels of alcohol and drug use. The findings have significant implications for community organizing, mental health support, and substance use prevention. While leveraging gayborhoods to foster support networks and improve mental health among Asian sexual minority men is beneficial, it is equally crucial to address the pressures associated with conforming to community norms, particularly regarding social drinking and recreational drug use.

While both individual- and neighborhood-level factors play a role in the progression from gestational diabetes mellitus (GDM) to type 2 diabetes mellitus (T2DM), few studies have simultaneously examined these two sets of factors. In this retrospective cohort study of 3567 women with a history of GDM, we used multilevel survival analysis to quantify T2DM risk associated with patient-level and neighborhood-level factors. During a mean follow-up of 2.2 years, 195 women (5.5%) developed T2DM. Statistically significant risk factors of T2DM progression included Black or Asian race, preeclampsia, family history of diabetes, and overweight or obesity. Importantly, residing in neighborhoods with a top tertile social deprivation index was also associated with increased risk (HR = 1.78, 95% CI: 1.01-3.14). In addition, after accounting for other factors, the residual clustering associated with neighborhoods conferred a 19% higher risk. Interventions addressing both individual- and neighborhood-level factors, including socioeconomic disparities, are critical to reducing the risk of T2DM in women with GDM.

Urban agriculture, known as urban farming, urban gardening, or community gardening, has become an important avenue for community development, food security, and economic stability in response to increased urbanization. However, a less studied aspect of urban agriculture is its application for historically marginalized communities and refugee and immigrant communities specifically. Using a two-fold research question: What are the domains of application of urban agriculture interventions on refugee and/or migrant populations? What are the scales and geographic patterns of urban agriculture interventions? Following scoping review guidelines, 42 articles published from 1990 to 2024 were included after screening out 375 articles that were initially retrieved from the database search. Articles were examined based on the following criterion: population of interest, intervention type, intervention scale, and geography of author. Findings suggest five domains of application: well-being, physical health, ecological, economic, and sociological, the latter as the most common domain. Health, particularly mental health, was less evident in scholarship. In terms of scale and geography, findings suggest that studies about large-size interventions were mostly in the Global South (Middle East and African regions specifically), and studies on small and medium-sized interventions were in the Global North (United States, Canada and Australia specifically). For theory, findings point to two broad theoretical domains: relationality and materialist, and less attention to food and environmental justice. These findings raise questions pertaining to access to resources insofar as resources determine the scale/size of interventions and thus their application. Issues pertaining to health and food and environmental justice were applications that largely did not emerge in the data, raising questions for further research.

Throughout the past 50 years, sustainable urban development models (SUDMs) have been introduced in cities across the world with the intention of limiting environmental air pollution and, more recently, greenhouse gas emissions. However, the health and wellbeing impacts that these interventions have had on different demographic groups are not well understood. Feminist urbanists have often critiqued hierarchical and non-participatory approaches to urban design for the detrimental impact they may have on women and minority groups. With x-minute neighborhood policies gaining popularity in urban planning across the world, gathering evidence on the potential gendered health and wellbeing inequalities impacts of these policies is a salient issue. Our research questions were as follows: (1) In the existing literature, what is known about the health and wellbeing impacts of SUDMs on women? (2) What mechanistic pathways are outlined in existing literature from SUDMs to gendered health outcomes? This review searched Medline, SCOPUS, Science Citation Index Expanded, Social Sciences Citation Index, and ASSIA. A broad range of outcomes was included in the search, from physical and mental health and wellbeing to health behaviors. We searched for empirical papers published in English before January 1st, 2024, without limiting the search by year or country of publication. Screening was performed on Rayyan with 15% of records double-screened. Critical appraisal was conducted using the AXIS tool for cross-sectional studies and CASP cohort checklist for longitudinal studies. Narrative synthesis was used to explore results in depth, with an effect-direction plot used to visually summarize findings. The initial search returned 1263 records. After duplicates were removed, 1194 records remained for screening. Of these, 301 were included for full-text screening, with 25 included for data extraction. Most of the included papers explored associations between SUDMs and women's physical activity. These relationships were typically positive, although some found no significant associations. Papers which explored the gendered mechanisms leading to outcomes tended to posit that having more convenient non-motorized access to a range of destinations on foot helped women to balance their paid and unpaid labor, leading to increased physical activity. Increased safety and reduced social isolation within SUDMs were also hypothesized as key contributing factors to women's increased physical activity. We found that there are research gaps in relation to mental health and long-term physical health outcomes.

Latinx residents in New York City experience greater disparities in alcohol use behaviors, chronic liver disease mortality, and other health and legal consequences from high-risk alcohol use compared to non-Latinx White residents. As media-based advertising of alcohol can influence health behaviors, this study aimed to take an "upstream" approach by analyzing rates of alcohol advertising across primetime English- and Spanish-language television networks and radio station broadcasting in New York City during September 7-27, 2022. A systematic content analysis of a randomly drawn, two-week composite sample of primetime YouTube television networks and radio stations revealed significantly higher alcohol advertising rates per hour on Spanish- than English-language media (rate difference across television networks = 4.91, 95% CI = 3.96, 5.85, p < 0.05; rate difference across radio stations = 1.86; 95% CI = 1.17, 2.55, p < 0.05). Findings underscore disparities in alcohol advertising across diverse media types, disadvantaging consumers of Spanish-language media. Stronger regulation and enforcement of alcohol marketing laws are needed to curb Latinx health inequities.

Timely access to comprehensive , high-quality emergency obstetric and neonatal care can prevent maternal and neonatal mortality but remains challenging in Benin. We examine geographic accessibility to childbirth care (CBC) in Grand Nokoué, the largest conurbation in Benin. We gathered data on boundaries, health facilities, road network, elevation, land cover, relative wealth, urbanicity, and geo-traced travel speeds over 45 days during the rainy season. We modelled travel times (TT) to health facility offering CBC (stratified by level and sector) using the least-cost path algorithm, based on slowest, average, and fastest travel speeds. We estimated the percentage of women of childbearing age (WoCBA) within 30, 60, and 120 min of the nearest facility by subnational areas. We explored inequalities in TT by wealth quintile and urbanicity gradient. TT to nearest facility at average speed was 8 min and 24 min at slowest speed. For hospitals, this was 31 and 106 min, respectively. TT ranged from 2 to 38 min across arrondissements at average speeds. At average speeds, all WoCBA lived within 30 min of a health facility and 71.6% of a hospital. At slowest speed, this decreased to 84.7% and 22.9%, respectively, with substantial variations across arrondissements. TT to hospitals at average speed was five-fold longer among women from the poorest (50 min) compared to the richest quintile, while TT was shorter in the core urban (27 min) relative to peri-urban (46 min). TT to CBC varied by wealth and urbanicity gradient and was longer at the slowest speeds. Targeting peri-urban areas and poorest WoCBA with longer TT will reduce inequities.

It is widely acknowledged that child mortality rates have been higher in rural than urban areas in sub-Saharan Africa (SSA); a phenomenon appreciated as the urban advantage. However, since at least the 1980s, this urban advantage has been narrowing, and in some cases reversing across SSA. While existing studies have primarily focused on establishing this relationship, few clearly define what constitutes urban or rural, with authors using different operationalizations. Even fewer explore the underlying drivers of change. Rural and urban health outcomes are associated with both the social determinants of health and the wider political economy of health systems. This study aims to elucidate the factors underpinning the narrowing urban advantage in by examining how such factors are differentially distributed and operate across urban and rural contexts. A scoping search was conducted for English-language peer-reviewed published articles after 1990 on urban and rural child health disparities in SSA. Databases used included PubMed, Embase, and Web of Science. Overall, 21 articles were included in the scope of this review. This review adhered to PRISMA-ScR guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews). This review examines the extent to which urban areas in SSA continue to confer a survival advantage in child mortality, and the mechanisms underlying shifts in this trend. Four key categories of determinants-environmental, healthcare-related, sociodemographic, and disease/morbidity-related-consistently emerge across the literature, though their significance and strength vary across rural and urban settings. Notably, the review identifies a growing influence of intra-urban inequality, driven by informal urbanization and the expansion of slums, as a central factor in the narrowing urban advantage. The operationalization of urbanicity and rurality was inconsistent across studies, and rigid geographical classifications often obscured important spatial and contextual nuances. These findings underscore the limitations of conventional rural-urban comparisons and highlight the need for more nuanced frameworks that reflect the complex, evolving landscape of urban poverty and child health in SSA. The spatial reconfiguration of urban poverty appears to be modifying the distribution of child health risks in manners not captured by traditional urban-rural comparisons. Future research should focus on employing an urban continuum in demographic research, accounting for intra-urban inequities within the context of rapid urbanization processes which are altering the urban health landscape, and reshaping the social determinants of child mortality across the urban-rural spectrum.

Parks have been associated with more physical activity and better health, but the relationship between health and how funds are expended for park programming, maintenance, or other expenses has not yet been investigated. For the largest 100 US cities, the average spending for parks and recreation in 2022-2023 was $126 per capita, with $37.59 per capita for programming and $63.11 per capita for maintenance. In contrast, the spending for health care in 2022 was $13,493 per capita. The goal of this study was to assess which allocations by Depts of Parks and Recreation are related to health outcomes. We tested the association between per capita spending in programming, maintenance, and total spending in 2022 by Depts. of Parks and Recreation in 10 Southern California cities and health outcomes among 732,504 adult members of Kaiser Permanente in 2022-2023 accounting for multiple factors. For every $30 per capita spent on programming, the prevalence ratios were lower: 0.87 for stroke (CI 0.84-0.90), 0.87 for heart failure (CI 0.84-0.89), 0.92 for atrial fibrillation (CI 0.90-0.95), 0.93 for coronary heart disease (CI 0.91-0.95), 0.94 for obesity (CI 0.93-0.95), 0.96 for type 2 diabetes (CI 0.95-0.97), and 0.96 for hypertension (CI 0.96-0.97). It is likely that programming has a stronger relationship than park maintenance with health outcomes because sports, exercise classes, and events (5 K walks and runs) more strongly attract park visitors and support physical activity (PA). While this novel study is promising, a longitudinal study is needed to prove causality.

The escalating threat of depression demands urgent action from the research community. As a policy that prioritizes a people-centered approach, the New-type Urbanization Policy (NTU) holds promise for alleviating depression. However, whether and how NTU positively affects individual mental health remains underexplored. This study draws on three waves of data from the China Health and Retirement Longitudinal Survey (CHARLS) and employs the difference-in-differences (DID) method as a quasi-natural experiment to empirically analyze the effects of NTU on individual depression. The results indicate that NTU significantly reduces depression, with environmental pollution serving as a mediator in this relationship. Moreover, NTU's impact on depression reduction is more pronounced in non-resource-based cities and those with lower population concentration. Additionally, the ecosocial theory emphasizes that health arises from the biological embodiment of structural exposures embedded in social and ecological environments. Based on this theory, it serves as a theoretical framework for analyzing NTU's impact on depression. This study expands the existing research on pilot policies related to individual health and provides concrete policy recommendations for mitigating depression in the context of NTU implementation.

The continuity of public transportation was necessary during the COVID-19 pandemic so that essential workers could report for duty. Therefore, it is important to consider COVID-19's impact on transit workers themselves. We described COVID-19 incidence rates over time in New York City (NYC) transit workers and the NYC general population during March-May, 2020. NYC transit COVID-19 cases were abstracted from occupational injury and illness logs, and health department data was used to ascertain NYC resident cases. COVID-19 rates among transit workers peaked during the week of March 22-28 (429.8 cases/100,000 workers). The peak in transit workers occurred 1-2 weeks before the general public's peak (March 29-April 4: 368.8 cases/100,000 people; April 5-11: 357.8 cases/100,000 people). These data suggest that NYC transit workers may have been impacted by COVID-19 earlier than the general public. Thus, improving early detection and response of respiratory disease outbreaks may be vital to protecting transit workers.