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Walking the Divide: A Public Health Journey from Manhattan to Harlem. 漫步鸿沟:从曼哈顿到哈莱姆的公共卫生之旅》。
Pub Date : 2024-01-01 Epub Date: 2024-08-11 DOI: 10.31586/jsmhes.2024.1018
Shervin Assari, Hossein Zare

This paper examines the striking contrasts and inequalities observation by walking from Manhattan to Harlem in New York City, highlighting the significant social and economic differences that have profound implications for public health and social policy. Through this journey, we explore various aspects including racial segregation, the composition of shops, smoking habits, street cleanliness, police presence, unemployment, real estate disparities, and the pervasive sense of insecurity. The transition from a predominantly White Manhattan to a predominantly Black and Hispanic Harlem underscores the historical and systemic inequalities that continue to shape the city's demographic and economic landscape. These disparities, rooted in discriminatory housing policies, economic disparities, and social exclusion, manifest in poorer health outcomes, higher rates of substance use, and limited economic opportunities for minority populations. By addressing these structural issues through targeted policies and sustained interventions, policymakers may work towards reducing health disparities and promoting racial equity. This paper also highlights the concept of Minorities' Diminished Returns (MDRs), where the benefits of education and income are less pronounced for minority individuals compared to their White counterparts, further perpetuating cycles of disadvantage. Comprehensive efforts to dismantle systemic inequities are essential for fostering a more equitable and healthy society.

本文探讨了从纽约市曼哈顿区步行到哈莱姆区所观察到的鲜明对比和不平等现象,突出强调了对公共卫生和社会政策具有深远影响的重大社会和经济差异。通过这次旅行,我们探讨了包括种族隔离、商店构成、吸烟习惯、街道清洁度、警力、失业率、房地产差距以及普遍存在的不安全感在内的各个方面。从白人占主导地位的曼哈顿到黑人和西班牙裔占主导地位的哈莱姆区,凸显了历史性和系统性的不平等,这些不平等继续影响着这座城市的人口和经济格局。这些不平等现象植根于歧视性住房政策、经济差距和社会排斥,表现为健康状况较差、药物使用率较高以及少数群体的经济机会有限。通过有针对性的政策和持续的干预措施来解决这些结构性问题,政策制定者可以努力缩小健康差距,促进种族公平。本文还强调了 "少数群体收益递减"(MDRs)的概念,即与白人相比,少数群体个人的教育和收入收益并不明显,这进一步延续了弱势循环。全面努力消除系统性的不平等对于建设一个更加公平和健康的社会至关重要。
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引用次数: 0
Extreme Heat Exposure Is Associated with Higher Socioeconomic Disadvantage and Elevated Youth Delinquency. 极端高温与较高的社会经济劣势和青少年犯罪率升高有关。
Pub Date : 2024-01-01 Epub Date: 2024-08-18 DOI: 10.31586/jsmhes.2024.1044
Shervin Assari, Hossein Zare

Background: Climate change has led to an increase in the frequency and intensity of extreme heat events, a trend expected to continue. This poses significant health risks, particularly for vulnerable populations like children. While previous research has largely concentrated on the physical health impacts of extreme heat, less attention has been given to behavioral outcomes, such as delinquency.

Objectives: This study investigates the association between extreme heat exposure and delinquency among children, utilizing data from the Adolescent Brain Cognitive Development (ABCD) study. It also explores the potential mediating roles of neighborhood socioeconomic status (SES; measured by median home value), puberty, peer deviance, and financial difficulties.

Methods: Data from the national ABCD study were analyzed to assess the relationship between extreme heat exposure (exposure) and delinquency (outcome). Covariates included race/ethnicity, sex, and age. Mediators examined were neighborhood SES, puberty, peer deviance, and financial difficulties. Structural equation modeling (SEM) was employed for data analysis.

Results: Overall, 11,878 children entered our analysis. The analysis revealed a significant association between extreme heat exposure and higher levels of delinquency among children. Children more exposed to extreme heat were more likely to be Black, reside in lower SES neighborhoods, experience greater financial difficulties, and have more advanced puberty status. The group facing the highest heat exposure was also economically disadvantaged.

Conclusions: The findings suggest that children already disadvantaged by socio-economic factors are disproportionately affected by extreme heat, leading to increased delinquency. This highlights the need for targeted interventions to protect these vulnerable populations and address the mediators of extreme heat exposure. Future research should focus on longitudinal studies and evaluate the effectiveness of various mitigation strategies to address these disparities.

背景:气候变化导致极端高温事件的频率和强度增加,预计这一趋势将持续下去。这给人们的健康带来了巨大风险,尤其是对儿童等弱势群体而言。以往的研究主要集中于极端高温对身体健康的影响,而对行为结果(如犯罪)的关注较少:本研究利用青少年大脑认知发展(ABCD)研究的数据,调查极端高温暴露与儿童犯罪之间的关联。研究还探讨了邻里社会经济地位(SES,以房屋价值中位数衡量)、青春期、同伴偏差和经济困难的潜在中介作用:分析了全国性 ABCD 研究的数据,以评估极热暴露(暴露)与犯罪(结果)之间的关系。协变量包括种族/民族、性别和年龄。研究的中介因素包括邻里社会经济地位、青春期、同伴偏差和经济困难。数据分析采用了结构方程模型(SEM):共有 11,878 名儿童参与了分析。分析结果表明,酷热与儿童犯罪率较高之间存在明显联系。更容易受到酷热影响的儿童更有可能是黑人、居住在社会经济地位较低的社区、经济困难更大、青春期更晚。面临最高高温的群体在经济上也处于不利地位:研究结果表明,由于社会经济因素而处于不利地位的儿童受到极端高温的影响尤为严重,从而导致犯罪率上升。这突出表明,有必要采取有针对性的干预措施来保护这些弱势人群,并解决极端高温暴露的媒介问题。未来的研究应侧重于纵向研究,并评估各种缓解策略对解决这些差异的有效性。
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引用次数: 0
Higher Neighborhood Crime Rates Don't Always Predict Early Initiation of Tobacco, Marijuana, and Alcohol. 较高的邻里犯罪率并不总能预测早期吸烟、吸食大麻和酗酒的情况。
Pub Date : 2024-01-01 Epub Date: 2024-08-24 DOI: 10.31586/jsmhes.2024.1049
Shervin Assari, Payam Sheikhattari

Background: The initiation of substance use during adolescence is a significant public health concern with long-term implications. Structural and environmental factors, such as community-level crime statistics related to drug offenses, are often assumed to influence the likelihood of substance use among youth. However, the relationship between these environmental crime indicators and early substance use initiation in adolescents is not well understood.

Objective: This study aims to examine the association between environmental drug-related crime statistics-derived from Uniform Crime Reports, including drug abuse violations, drug sales, marijuana sales, drug possession, and driving under the influence (DUI)-and the use of tobacco, marijuana, and alcohol among adolescents aged 9-16 in the United States.

Methods: Data from the Adolescent Brain Cognitive Development (ABCD) study, which follows a cohort of adolescents from ages 9-10 to 16, were analyzed. 11,878 participants entered our analysis. The primary environmental measures included total drug abuse violations, drug sale offenses, marijuana sale offenses, drug possession offenses, and DUI reports. Substance use outcomes of interest were the frequency and prevalence of tobacco, marijuana, and alcohol use across the observed age range.

Results: Contrary to expectations, higher levels of drug-related crime in a community were not associated with increased use of tobacco, marijuana, or alcohol among adolescents. In fact, the study found a significant inverse relationship between the total number of drug-related crimes and tobacco use, suggesting lower tobacco use in areas with higher reported drug abuse violations, drug sales, marijuana sales, drug possession, and DUI incidents. No significant associations were observed between these crime indicators and the use of marijuana or alcohol.

Conclusions: These findings challenge the prevailing assumption that higher environmental drug-related crime statistics necessarily predict greater substance use among adolescents. The observed inverse relationship between drug-related crime and tobacco use warrants further investigation to understand the underlying mechanisms and to inform targeted intervention strategies. Future research should explore the complex interplay between structural environmental factors and youth substance use to better inform public health policies.

背景:青少年时期开始使用药物是一个具有长期影响的重大公共卫生问题。结构和环境因素(如与毒品犯罪有关的社区犯罪统计数据)通常被认为会影响青少年使用药物的可能性。然而,人们对这些环境犯罪指标与青少年过早开始使用药物之间的关系还不甚了解:本研究旨在调查美国 9-16 岁青少年中与毒品相关的环境犯罪统计数据(包括药物滥用违法行为、毒品销售、大麻销售、持有毒品和酒驾等)与烟草、大麻和酒精使用之间的关系:我们对青少年大脑认知发展(ABCD)研究的数据进行了分析,该研究对 9-10 岁至 16 岁的青少年进行了跟踪调查。共有 11,878 名参与者参与了分析。主要的环境测量指标包括药物滥用违规行为总数、药物销售违规行为、大麻销售违规行为、持有毒品违规行为和酒驾报告。我们感兴趣的物质使用结果是在观察到的年龄范围内烟草、大麻和酒精使用的频率和流行率:结果:与预期相反,社区中与毒品有关的犯罪率越高,青少年使用烟草、大麻或酒精的比例就越高。事实上,研究发现与毒品有关的犯罪总数与烟草使用量之间存在显著的反比关系,这表明在举报违反药物滥用规定、销售毒品、销售大麻、持有毒品和酒驾事件较多的地区,烟草使用量较低。在这些犯罪指标与大麻或酒精的使用之间没有观察到明显的关联:这些研究结果对普遍认为环境中与毒品有关的犯罪统计数据越高,青少年使用毒品的比例就越高这一假设提出了质疑。观察到的毒品相关犯罪与烟草使用之间的反向关系值得进一步研究,以了解其背后的机制,并为有针对性的干预策略提供依据。未来的研究应探索结构性环境因素与青少年药物使用之间复杂的相互作用,以便更好地为公共卫生政策提供信息。
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引用次数: 0
Paradoxical Effects of Income and Income Inequality on Racial Health Disparities. 收入和收入不平等对种族健康差异的矛盾影响。
Pub Date : 2024-01-01 Epub Date: 2024-07-27 DOI: 10.31586/jsmhes.2024.998
Shervin Assari, Hossein Zare

The intersection of race and place in shaping health disparities presents complex dynamics, as evidenced by studies in cities like Detroit, Baltimore, and Philadelphia, where predominantly Black and economically disadvantaged populations experience high overall rates of health problems. Surprisingly, these cities do not exhibit the most pronounced racial disparities. In contrast, areas with a higher percentage of White residents, indicative of greater income inequality, show stark differences in health outcomes between Black and White populations. This disparity underscores how conditions diverge more sharply between Black and White individuals in wealthier urban areas. This phenomenon suggests a complex and sometimes counterintuitive relationship among race, place, income, and income inequality in shaping racial health disparities. These dynamics have significant policy implications. Addressing health disparities requires nuanced strategies that recognize the multiplicative effects of race and income inequality on health outcomes. Policies focusing on areas with a high disease burden, such as Detroit, Philadelphia, and Baltimore can effectively mitigate disparities both locally and more broadly. Conversely, interventions targeting regions with lower disease prevalence, but higher racial disparities must be approached carefully to avoid exacerbating inequalities. In conclusion, understanding and addressing the complex drivers of health disparities demand comprehensive approaches that acknowledge the intertwined influences of race, income, and place. By prioritizing interventions that address economic disparities alongside health initiatives, policymakers can foster more equitable health outcomes across diverse communities.

在底特律、巴尔的摩和费城等城市,以黑人和经济弱势人群为主的总体健康问题发生率很高。令人惊讶的是,这些城市并没有表现出最明显的种族差异。与此相反,白人居民比例较高的地区(表明收入更加不平等),黑人和白人之间的健康结果却存在明显差异。这种差异突出表明,在较富裕的城市地区,黑人和白人的健康状况差异更大。这一现象表明,在形成种族健康差异的过程中,种族、地方、收入和收入不平等之间存在着复杂的、有时甚至是反直觉的关系。这些动态变化具有重要的政策影响。解决健康差距问题需要采取细致入微的策略,认识到种族和收入不平等对健康结果的倍增效应。以底特律、费城和巴尔的摩等疾病负担较重的地区为重点的政策,可以有效缓解当地和更广泛范围内的差距。相反,针对疾病发病率较低但种族差异较大的地区的干预措施必须谨慎对待,以避免加剧不平等。总之,要了解和解决健康差距的复杂驱动因素,就必须采取全面的方法,承认种族、收入和地区的交织影响。通过优先采取干预措施,在解决经济差距的同时解决健康问题,政策制定者可以在不同社区促进更公平的健康结果。
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引用次数: 0
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