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Abstract: Abstract This study investigates the impact of racial residential segregation on COVID-19 mortality during the first year of the US epidemic. Data comes from the Center for Disease Control and Prevention (CDC), and the Robert Wood Johnson Foundation's and the University of Wisconsin's joint county health rankings project. The observation includes a record of 8,670,781 individuals in 1488 counties. We regressed COVID-19 deaths, using hierarchical logistic regression models, on individual and county-level predictors. We found that as racial residential segregation increased, mortality rates increased. Controlling for segregation, Blacks and Asians had a greater risk of mortality, while Hispanics and other racial groups had a lower risk of mortality, compared to Whites. The impact of racial residential segregation on COVID-19 mortality did not vary by racial group. PubDate: 2023-09-15
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Abstract: Abstract Firearm-related interpersonal violence is a leading cause of death and injury in cities across the United States, and understanding the movement of firearms from on-the-books sales to criminal end-user is critical to the formulation of gun violence prevention policy. In this study, we assemble a unique dataset that combines records for over 380,000 crime guns recovered by law enforcement in California (2010–2021), and more than 126,000 guns reported stolen, linked to in-state legal handgun transactions (1996–2021), to describe local and statewide crime gun trends and investigate several potentially important sources of guns to criminals, including privately manufactured firearms (PMFs), theft, and “dirty” dealers. We document a dramatic increase over the decade in firearms recovered shortly after purchase (7% were recovered within a year in 2010, up to 33% in 2021). This corresponds with a substantial rise in handgun purchasing over the decade, suggesting some fraction of newly and legally acquired firearms are likely diverted from the legal market for criminal use. We document the rapid growth of PMFs over the past 2–3 years and find theft plays some, though possibly diminishing, role as a crime gun source. Finally, we find evidence that some retailers contribute disproportionately to the supply of crime guns, though there appear to be fewer problematic dealers now than there were a decade ago. Overall, our study points to temporal shifts in the dynamics of criminal firearms commerce as well as significant city variation in the channels by which criminals acquire crime guns. PubDate: 2023-09-11
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Abstract: Abstract Assess the preliminary impact of Brave Technology Co-op’s overdose detection devices that have been implemented in housing, medical, social service facilities, and several private settings in North America. Administrative data was collected by Brave on their Buttons and Sensors during several proof-of-concept projects and full installations in Canada and United States (US) between December 2018 and July 2022. Data analyzed provided insights on the number of overdoses detected and reversed (averted overdose deaths) using Brave Sensors and Buttons, along with other programmatic and session-specific indicators. Implementation of 486 Brave Buttons and 148 Brave Sensors in Canada has detected and prevented 108 overdose deaths (100 using Buttons and 8 using Sensors) whereas implementation of 170 Buttons in the US has averted 2 overdose deaths to date, with the potential to save many more lives. Brave’s devices hold promise for increasing rates of overdose detection and preventing overdose deaths. PubDate: 2023-09-05
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Abstract: Abstract This study examines the relationship between designated Mental Health Professional Shortage Areas (MH HPSAs) and mental health-related 911 calls in New York City. Negative binomial regression models were used to estimate the relationship between MH HPSAs and MH 911 calls after adjusting for the population size and other neighborhood characteristics. The study found that neighborhoods designated as MH HPSAs had higher MH 911 calls compared to non-shortage areas, with a 27% increase in expected MH 911 calls after adjustment. Moreover, the results indicated that neighborhoods with higher rates of homelessness and poverty generated more MH 911 calls. The findings suggest a need to improve access to mental health services to reduce the burden on police and emergency services for crisis interventions in areas with limited resources. PubDate: 2023-08-28
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Abstract: Abstract Using the Future of Families and Child Wellbeing Study (N = 785), this article considers the ramifications of police use of racial slurs, a type of intrusive behavior, toward minority youth for posttraumatic stress (PTS). We also examine whether other intrusive police behaviors exacerbate this relationship and test whether perceptions of injustice mediate it. Results indicated that hearing a police officer use a racial slur was positively associated with PTS after controlling for intrusive police behaviors and other covariates. Intrusive policing tended to co-occur with the use of racial slurs and was positively associated with PTS. The association between hearing a racial slur and PTS did not vary by the number of intrusive behaviors exhibited by police. The association between hearing a slur and PTS was partially mediated by perceived procedural injustice. Overall, the use of racial slurs by police may do harm to minority adolescents by putting them at risk for posttraumatic stress disorder. Our results are consistent with prior research that racial slurs may contribute to PTS by eroding the bounds of what is considered just and fair. Interestingly, the association between racial slurs and PTS was independent of other intrusive policing behaviors. Mental health screeners should ask not only about being stopped by police but the characteristics of that encounter as well — including those imbued with racial animus. PubDate: 2023-08-25
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Abstract: Abstract The COVID-19 pandemic has dramatically altered people’s lives in multiple aspects, including grocery shopping behaviors. Yet, the changing trend of grocery shopping frequencies during the COVID-19 and its associations with food deserts remain unclear. We aimed to (1) examine variations of grocery shopping frequencies at county level in the USA during the COVID-19 pandemic from March 2020 to December 2021; (2) investigate associations between grocery shopping frequencies and food deserts during the COVID-19 pandemic; and (3) explore heterogeneity in grocery shopping frequencies—food desert associations across urban and rural areas. The county-level grocery shopping frequencies were derived from a grocery pattern dataset obtained from SafeGraph. We divided the 22-month period into 5 stages and employed the growth curve modeling to estimate the trajectories of grocery shopping frequencies and the associations between grocery shopping frequencies and food deserts in each stage, separately. Results revealed that grocery shopping frequencies experienced a “W-shaped” pattern from March 2020 to December 2021. Counties with the least percent of food deserts had slower decrease in grocery shopping frequencies at the initial stage and recovered more rapidly at later stages. Counties with the highest percent of food deserts were subject to deprivation amplification as a result of the pandemic. We also found differences existed in the grocery shopping frequencies—food desert associations between metropolitan counties and rural counties. Our findings suggest the impacts of COVID-19 on grocery shopping frequencies varied across different time periods, shedding light on designing different strategies to reduce the risk of contagion while shopping inside of grocery stores. Further, our findings highlight an urgent need to help people living in food deserts (especially in rural counties) to procure healthy foods safely during health emergencies like COVID-19 pandemic which disrupt mobility and social behaviors. PubDate: 2023-08-21
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Abstract: Abstract Municipalities can foster the social participation of aging adults. Although making municipalities age-friendly is recognized as a promising way to help aging adults stay involved in their communities, little is known about the key components (e.g., services and structures) that foster social participation. This study thus aimed to identify key age-friendly components (AFC) best associated with the social participation of older Canadians. Secondary analyses were carried out using baseline data from the Canadian Longitudinal Study on Aging (n = 25,411) in selected municipalities (m = 110 with ≥ 30 respondents), the Age-friendly Survey, and census data. Social participation was estimated based on the number of community activities outside the home per month. AFC included housing, transportation, outdoor spaces and buildings, safety, recreation, workforce participation, information, respect, health, and community services. Multilevel models were used to examine the association between individual social participation, key AFC, and environmental characteristics, while controlling for individual characteristics. Aged between 45 and 89, half of the participants were women who were engaged in 20.2±12.5 activities per month. About 2.5% of the variance in social participation was attributable to municipalities. Better outdoor spaces and buildings (p < 0.001), worse communication and information (p < 0.01), and lower material deprivation (p < 0.001) were associated with higher social participation. Age was the only individual-level variable to have a significant random effect, indicating that municipal contexts may mediate its impact with social participation. This study provides insights to help facilitate social participation and promote age-friendliness, by maintaining safe indoor and outdoor mobility, and informing older adults of available activities. PubDate: 2023-08-18
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Abstract: Abstract Compared to previous studies commonly using a single summary score, we aimed to construct a multidomain neighborhood environmental vulnerability index (NEVI) to characterize the magnitude and variability of area-level factors with the potential to modify the association between environmental pollutants and health effects. Using the Toxicological Prioritization Index framework and data from the 2015–2019 U.S. Census American Community Survey and the 2020 CDC PLACES Project, we quantified census tract-level vulnerability overall and in 4 primary domains (demographic, economic, residential, and health status), 24 subdomains, and 54 distinct area-level features for New York City (NYC). Overall and domain-specific indices were calculated by summing standardized feature values within the subdomains and then aggregating and weighting based on the number of features within each subdomain within equally-weighted primary domains. In citywide comparisons, NEVI was correlated with multiple existing indices, including the Neighborhood Deprivation Index (r = 0.91) and Social Vulnerability Index (r = 0.87) but provided additional information on features contributing to vulnerability. Vulnerability varied spatially across NYC, and hierarchical cluster analysis using subdomain scores revealed six patterns of vulnerability across domains: 1) low in all, 2) primarily low except residential, 3) medium in all, 4) high demographic, economic, and residential 5) high economic, residential, and health status, and 6) high demographic, economic and health status. Created using methods that offer flexibility for theory-based construction, NEVI provided detailed vulnerability metrics across domains that can inform targeted research and public health interventions aimed at reducing the health impacts from environmental exposures across urban centers. PubDate: 2023-08-18
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Abstract: Abstract Exposure to chronic stress is a major public health concern. Black youth are vulnerable to chronic stress exposure given their overrepresentation in urban neighborhoods characterized by socio-ecological stressors. We contribute to this emerging body of knowledge by (1) investigating stress-induced variability in cortisol response patterns among Black youth, and (2) examining risk and protective factors associated with physiological stress responses. Salivary cortisol was collected from a community sample of 123 low-income Black youth ages 13 to 21. Latent class analysis (LCA) and logistic regression were utilized to identify discrete groups based on cortisol reactivity, and psychological, behavioral, and socio-ecological correlates of class membership. LCA supported a 2-class model of cortisol reactivity. Youth in class one were indicative of a normative stress response with mean cortisol awakening response of 0.38 μg/dL (SD = 0.19), 0.48 μg/dL (SD = 0.20) at time 2, and 0.44 μg/dL (SD = 0.20) at time 3. Youth in class two exhibited a blunted stress response with mean cortisol awakening response of 0.20 μg/dL (SD = 0.11), 0.21 μg/dL (SD = 0.09) at time 2, and 0.18 μg/dL (SD = 0.08) at time 3. Delinquent peer exposure and post-traumatic stress symptoms were negatively associated with blunted stress responses, while greater depressive symptoms were positively associated with blunted stress responses. Black youth displayed distinct physiological stress reactivity patterns. Interventions are needed to assist youth in coping with stress while transforming the upstream factors that give rise to adverse community conditions. PubDate: 2023-08-16
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Abstract: Abstract We examined the impact of the first year of the COVID-19 pandemic on unmet healthcare need among New Yorkers and potential differences by race/ethnicity and health insurance. Data from the Community Health Survey, collected in 2018, 2019, and 2020, were merged to compare unmet healthcare need within the past 12 months during the pandemic versus the 2 years prior to 2020. Univariate and multivariable logistic regression models evaluated change in unmet healthcare need overall, and we assessed whether race/ethnicity or health insurance status modified the association. Overall, 12% of New Yorkers (N = 27,660) experienced unmet healthcare during the 3-year period. In univariate and multivariable models, the first year of the pandemic (2020) was not associated with change in unmet healthcare need compared with 2018–2019 (OR = 1.04, p = 0.548; OR = 1.03, p = 0.699, respectively). There was no statistically significant interaction between calendar year and race/ethnicity, but there was significant interaction with health insurance status (interaction p = 0.009). Stratifying on health insurance status, those uninsured had borderline significant lower odds of experiencing unmet healthcare need during 2020 compared to the 2 years prior (OR = 0.72, p = 0.051) while those with insurance had a slight increase that was not significant (OR = 1.12, p = 0.143). Unmet healthcare need among New Yorkers during the first year of the pandemic did not differ significantly from 2018-2019. Federal pandemic relief funding, which offered no-cost COVID-19 testing and care to all, irrespective of health insurance or legal status, may have helped equalized access to healthcare. PubDate: 2023-08-15
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Abstract: Abstract There is evidence that higher street connectivity and availability of destinations can support walking behavior. However, the availability of data and comparability between previous studies remain a challenge. Based on a large Canadian adult sample, this study examined the associations between street layout and walking behaviors and explored whether objectively measured destinations may mediate these relationships. This study used data from 12,378 adults from Alberta’s Tomorrow Project (ATP), a prospective cohort study conducted in Alberta, Canada. Walking behaviors were obtained by questionnaires. Street layout and destination measures were calculated objectively. Covariate-adjusted multivariate linear models estimated the associations between the space syntax street integration and duration of transport and leisure walking. The mediation effects of the availability of destinations in these associations were tested by the structural equation modelling. Street integration was significantly positively associated with transportation walking (b=0.01, 95% CI 0.00, 0.01, p = 0.01) (indirect effect). The availability of destinations partially mediated this association. Using the natural movement theory in space syntax, our study provides insights into using street layouts as a primary measure to (re)design the built environment to support walking. PubDate: 2023-08-15
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Abstract: Abstract Residential segregation has been considered as a potential cause of racial and/or ethnic disparities in health. Among the five dimensions of residential segregation, the isolation dimension has been conceived to play an essential role in disproportionately shaping the health of racial and ethnic minorities, particularly in urban or metropolitan areas. However, a noticeable amount of research studies has been using informal measures of neighborhood composition (i.e., proportions or percentages), which do not capture any of the five dimensions of residential segregation. Since the inappropriateness of measurement may obstruct a meaningful interpretation and an effective dissemination of research findings, a combination of graphical and non-graphical techniques was used to demonstrate the similarities and differences between formal measures of neighborhood-level residential isolation and informal measures of neighborhood composition. These were intended to provide intuitive and mutual understandings across academic disciples (e.g., city or urban planning, geography, public health, and sociology) and practitioners or professionals in multiple fields (e.g., community development workers, health service providers, policymakers, and social workers). Conceptual and methodological explanations with analytical discussions are also provided to differentiate and/or distinguish the two types of measures. While the concepts, methodologies, and research implications discussed herein are most relevant for research studies in urban or metropolitan areas of the United States, the general framework is also applicable to those of other industrialized counties. PubDate: 2023-08-15
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Abstract: Abstract The 2022–2023 mpox outbreak has disproportionately impacted gay, bisexual, and other men who have sex with men (GBMSM). The US CDC recommended individuals to explore safer sexual practices that minimize the potential risk of exposure and also strongly encouraged for eligible individuals to prioritize vaccination. This study aimed to analyze social media data related to mpox on Reddit since the mpox outbreak and identify themes associated with the impact on social behaviors and social processes among targeted population. Publicly available data were collected from the social media Reddit. We extracted the summarized mpox-related posts since the beginning of May 2022 from popular subreddits that were popular among GBMSM. We thematically analyzed the content to identify the overall themes related to the GBMSM’s responses to the outbreak. There is an overall increase in the number of daily mpox-related posts, with three upticks in late May, late July, and early August 2022, which may correspond to the dates that the first mpox case was identified in the USA, the WHO declared a global public health emergency, and the US Department of Health and Human Services declared a public health emergency. Four themes were identified: (1) changes in sexual behaviors and social activities; (2) mpox vaccine attitude, uptake, and hesitancy; (3) perceived and experienced stigma and homophobia, and mental distress; and (4) online information-seeking and mutual aid and support. GBMSM changed their sexual behaviors and social activities to mitigate their exposure to the virus during this outbreak and actively sought and shared information about mpox vaccination in their respective settings, while some were hesitant due to concerns about side effects and potential effectiveness. Perceived and experienced stigma and discrimination on gay- and same sex-identify have impacted GBMSM’s mental health. Interventions to promote the mpox vaccine must address the historical medical mistrust and vaccine hesitancy among GBMSM. PubDate: 2023-08-14
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Abstract: Abstract The Great Migration was a movement of roughly eight million Black Southerners relocating to the North and West from 1910 to 1980. Despite being one of the most significant mass internal migrations during the twentieth century, little is known about the health outcomes resulting from migration and whether migrators’ destination choices were potential mechanisms. This study measured the association between destination county disadvantage and odds of low birth weight during the last decade of the Great Migration. We used the US Census from 1970 as well as the birth records of first-time Black mothers who migrated from the South collected through the National Center of Health Statistics from 1973 to 1980 (n = 154,145). We examined three measures of area-based opportunity: Black male high school graduation rate, Black poverty rate, and racialized economic residential segregation. We used multilevel logistic regression, where mothers were nested within US counties, to quantify the relationship between county disadvantage and low birth weight. After adjusting for individual risk and protective factors for infant health, there was no relationship between county opportunity measures and low birth weight among migrators. Although high socioeconomic opportunity is typically associated with protection of low birth weight, we did not see these outcomes in this study. These results may support that persistent racial discrimination encountered in the North inhibited infant health even as migrators experienced higher economic opportunity relative to the South. PubDate: 2023-08-14
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Abstract: Abstract Long-acting injectable antiretroviral therapy (LAI-ART) is a novel method to deliver HIV treatment, and the first regimen was approved in the USA in 2021. LAI-ART may mitigate barriers to oral treatment adherence, but little is known about LAI-ART perceptions among people living with HIV (PLWH) who use drugs, despite these populations facing greater barriers to treatment retention and ART adherence. We assessed LAI-ART perceptions and implementation considerations among PLWH who use drugs and health and ancillary service providers in Rhode Island. Data was collected from November 2021 to September 2022, and include in-depth interviews with 15 PLWH who use drugs and two focus groups with HIV clinical providers (n = 8) and ancillary service providers (n = 5) working with PLWH who use drugs. Data were analyzed thematically, with attention paid to how levels of structural vulnerability and social-structural environments shaped participants’ LAI-ART perceptions and the HIV care continuum. Willingness to consider LAI-ART was impacted by HIV outcomes (e.g., viral suppression) and previous experiences with oral regimens, with those on stable regimens reluctant to consider alternative therapies. However, LAI-ART was seen as potentially improving HIV outcomes for PLWH who use drugs and enhancing people’s quality of life by reducing stress related to daily pill-taking. Recommendations for optimal implementation of LAI-ART varied across participants and included decentralized approaches to delivery. HIV care delivery must consider the needs of PLWH who use drugs. Developing patient-centered and community-based delivery approaches to LAI-ART may address adherence challenges specific to PLWH who use drugs. PubDate: 2023-08-10
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Abstract: Abstract A great deal of literature has examined features of the physical built environment as predictors of opioid overdose and other substance use-related outcomes. Other literature suggests that social characteristics of settings are important predictors of substance use outcomes. However, there is a dearth of literature simultaneously measuring both physical and social characteristics of settings in an effort to better predict opioid overdose. There is also a dearth of literature examining built environment as a predictor of overdose in non-urban settings. The present study presents a novel socio-built environment index measure of opioid overdose risk comprised of indicators measuring both social and physical characteristics of settings — and developed for use in both urban and non-urban settings — and assesses its validity among 565 urban, suburban, and rural New Jersey municipalities. We found that this novel measure had good convergent validity, based on significant positive associations with a social vulnerability index and crime rates, and significant negative associations with a municipal revitalization index and high school graduation rates. The index measure had good discriminant validity, based on lack of association with three different racial isolation indices. Finally, our index measure had good health outcome-based criterion validity, based on significant positive associations with recent overdose mortality. There were no major differences between rural, suburban, and urban municipalities in validity analysis findings. This promising new socio-built environment risk index measure could improve ability to target and allocate resources to settings with the greatest risk, in order to improve their impact on overdose outcomes. PubDate: 2023-08-07
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Abstract: Abstract The United States combine high rates of firearm homicides with high gun prevalence. In the past, a significant positive association was found between the two. This study revisits the gun prevalence-gun homicide debate using more elaborate estimates of gun ownership for the 50 States. Longitudinal data (1999–2016) were analysed with Bayesian multilevel Gamma-Poisson models. The results demonstrated a very small positive association that diminished after adjusting for crime rates. Findings suggest that the association either attenuated in more recent years, or previous studies had overestimated this association. PubDate: 2023-08-01
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Abstract: Abstract Vacant and abandoned buildings are common features in many post-industrial US cities, and are consistent predictors of violence. Demolition programs are regularly employed as an urban land use policy to stabilize housing markets and mitigate public health problems including violence. The objective of this research was to examine the effect of vacant building removals on violent and property crimes in Baltimore, MD from 2014 to 2019. We conducted a difference-in-differences analysis using spatio-temporal Bayesian mixed models on six crime types on block faces with and without building removals, before compared with after removal. There were significant reductions in total, violent crimes (with and without assaults), thefts, and burglaries on block faces with building removals relative to their controls. Total crimes decreased 1.4% per mi2 (CrI: 0.5 – 2.3%), which translates to a relative reduction ~ 2.6 total crimes per mi2 per year. The largest relative decreases in crime were found among assaults (4.9%; CrI: 3.4 – 6.3%) and violent crimes (3.0%; CrI: 1.9 – 4.1%). Building removals were associated with relative reductions in crime in Baltimore City. The relative reductions in crime, at building removals compared to at control vacant lots, were found among assaults and violent crimes, the crimes of greatest public health concern. Building removals provide co-benefits to their communities, and may be considered part of a crime reduction strategy compatible with other approaches. A systematic effort to understand the role of care for remaining vacant lots could further inform our findings, and efforts to further decrease violence and improve community health. PubDate: 2023-08-01
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