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McCain, Dextiny, Adrienne Aiken Morgan, Karon Phillips, and Keith Whitfield. "Physical Activity and Neighborhood Socioeconomic Disadvantage Among Low-Income African Americans." Innovation in Aging 4, Supplement_1 (December 1, 2020): 397–98. http://dx.doi.org/10.1093/geroni/igaa057.1279.
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Abstract Research shows regular physical activity (PA) is associated with better health and longevity; however, few studies consider contextual factors related to PA among African American (AA) older adults living in socioeconomically disadvantaged neighborhoods. The Physical and Cognitive Health Pilot Study (n=50) was used to examine associations between PA and level of neighborhood socioeconomic disadvantage among sedentary, AA older adults from four public housing communities in Durham, NC and Annapolis, MD (mean age=64.5; SD=10.42; 72% women). Participants were administered the Community Healthy Activities Model Program for Seniors (CHAMPS), a self-report questionnaire measuring weekly frequency and duration of PAs. Neighborhood socioeconomic disadvantage was defined by the Neighborhood Atlas Area Deprivation Index (ADI), which ranks neighborhoods according to Census block group/neighborhoods within each state and nationally. For the present sample, two of the Durham housing facilities were located in communities in the most disadvantaged block groups. Meanwhile, one Durham location and the Annapolis community were located in the least disadvantaged block groups. Bivariate correlations showed greater neighborhood socioeconomic disadvantage was associated with less participation in various PAs (p<.05). Next, ANOVA revealed the Annapolis group participated in statistically significantly more PAs, including visiting the senior center, church attendance, and light gardening (p<.05) compared to the most disadvantaged groups. The present findings suggest there are benefits to living in advantaged contexts despite lower-income status. These findings also suggest barriers within disadvantaged neighborhoods that limit access to recreational activities favorable to health status. Future research should address ways to overcome such barriers.
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Hu, Jianhui, Amy J. H. Kind, and David Nerenz. "Area Deprivation Index Predicts Readmission Risk at an Urban Teaching Hospital." American Journal of Medical Quality 33, no. 5 (January 22, 2018): 493–501. http://dx.doi.org/10.1177/1062860617753063.
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A growing body of evidence has shown that neighborhood characteristics have significant effects on quality metrics that evaluate health plans or health care providers. Using a data set of an urban teaching hospital patient discharges, this study aimed to determine whether a significant effect of neighborhood characteristics, measured by the Area Deprivation Index, could be observed on patients’ readmission risk, independent of patient-level clinical and demographic factors. This study found that patients residing in more disadvantaged neighborhoods had significantly higher 30-day readmission risks compared to those living in less disadvantaged neighborhoods, even after accounting for individual-level factors. Those who lived in the most extremely socioeconomically challenged neighborhoods were 70% more likely to be readmitted than their counterparts who lived in less disadvantaged neighborhoods. These findings suggest that neighborhood-level factors should be considered along with individual-level factors in future work on adjustment of quality metrics for social risk factors.
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Ross, Catherine E., John Mirowsky, and Shana Pribesh. "Disadvantage, Disorder, and Urban Mistrust." City & Community 1, no. 1 (March 2002): 59–82. http://dx.doi.org/10.1111/1540-6040.00008.
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Does life in the city foster mistrust of others? This study tests four connected hypotheses about urban mistrust by comparing the City of Chicago to suburbs, small cities, towns, and rural areas. The Urban Mistrust Hypothesis is that urban residents are more mistrusting than residents of places outside the city. The Neighborhood Disadvantage Hypothesis is that mistrust increases with the prevalence of economic and social disadvantage in one's neighborhood, which accounts for some of the mistrust associated with urban residence. The Individual Disadvantage Hypothesis is that socioeconomically disadvantaged individuals are more mistrusting than others, which accounts for some of the mistrust associated with residence in Chicago and in disadvantaged neighborhoods. The Neighborhood Disorder Hypothesis is that mistrust correlates positively with observing signs of disorder in one's neighborhood such as graffiti, vandalism, run‐down or abandoned buildings, noise, crime, and people hanging out on the streets, drinking, or taking drugs; and disorder mediates some of the effects of residence in the city and in a disadvantaged neighborhood. Some, but not all, of the association between disorder and mistrust is mediated by criminal victimization. We examine these hypotheses using the Community, Crime and Health data, which is a 1995 survey of a representative sample of 2,482 Illinois residents linked to contextual data on their neighborhoods. We find results consistent with all four hypotheses. The mean level of mistrust reported by residents of Chicago is more than half a standard deviation above that of people living elsewhere. Most of the higher mistrust in Chicago can be attributed to three related things: neighborhood disadvantage, individual disadvantage, and neighborhood disorder; but even with adjustments for disadvantage and disorder, urban residents report more mistrust.
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Mullins, Teagan S., Ethan M. Campbell, and Jeremy Hogeveen. "Neighborhood Deprivation Shapes Motivational-Neurocircuit Recruitment in Children." Psychological Science 31, no. 7 (June 30, 2020): 881–89. http://dx.doi.org/10.1177/0956797620929299.
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Implementing motivated behaviors on the basis of prior reward is central to adaptive human functioning, but aberrant reward-motivated behavior is a core feature of neuropsychiatric illness. Children from disadvantaged neighborhoods have decreased access to rewards, which may shape motivational neurocircuits and risk for psychopathology. Here, we leveraged the unprecedented neuroimaging data from the Adolescent Brain Cognitive Development (ABCD) study to test the hypothesis that neighborhood socioeconomic disadvantage shapes the functional recruitment of motivational neurocircuits in children. Specifically, via the ABCD study’s monetary-incentive-delay task ( N = 6,396 children; age: 9–10 years), we found that children from zip codes with a high Area Deprivation Index demonstrate blunted recruitment of striatum (dorsal and ventral nuclei) and pallidum during reward anticipation. In fact, blunted dorsal striatal recruitment during reward anticipation mediated the association between Area Deprivation Index and increased attention problems. These data reveal a candidate mechanism driving elevated risk for psychopathology in children from socioeconomically disadvantaged neighborhoods.
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Kim, Young-Jae, and Eun Jung Kim. "Neighborhood Greenery as a Predictor of Outdoor Crimes between Low and High Income Neighborhoods." International Journal of Environmental Research and Public Health 17, no. 5 (February 25, 2020): 1470. http://dx.doi.org/10.3390/ijerph17051470.
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Neighborhood greenery contributes to improving mental, emotional, and physical health and may help to promote neighborhood safety. Several studies have reported positive effects of neighborhood greenery on the improvement of outdoor safety, but little is known about whether the relationship between green vegetation and outdoor safety varies with the income status of neighborhoods. The purpose of this study is to examine neighborhood greenery as a predictor of outdoor crime rates between low and high-income neighborhoods while controlling for the sociodemographic conditions of the neighborhoods. This study used 2010 census block group data and objectively measured natural environment data derived from GIS in Austin, Texas. Comparison t-tests and ordinal least square regressions were conducted as statistical analyses. The t-tests showed that low-income neighborhoods were more socioeconomically disadvantaged and had less greenery than high-income neighborhoods. The final regression models showed that neighborhood greenery had a negative relationship with outdoor crimes for low-income neighborhoods but a positive relationship with crimes for high-income neighborhoods. The results suggest that different strategies may be needed in dealing with neighborhood safety according to neighborhood-level income.
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Webb, E. Kate, Carissa Weis, Ken Bennett, Ashley Huggins, Elizabeth Parisi, Jessica Krukowski, Terri deRoon-Cassini, and Christine Larson. "68415 Neural Impact of Neighborhood Disadvantage in Traumatically-Injured Adults: a Multi-Modal Investigation." Journal of Clinical and Translational Science 5, s1 (March 2021): 22–23. http://dx.doi.org/10.1017/cts.2021.462.
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ABSTRACT IMPACT: Neighborhood disadvantage was significantly associated with brain structure and function in trauma-exposed adults, providing evidence that contextual factors should be assessed in mental health research, particularly in high-risk populations. OBJECTIVES/GOALS: Over 13 percent of Americans live in a socioeconomically disadvantaged neighborhood. Previous work has linked lower individual socioeconomic position to alterations in brain structure and function. However, the neural effects of area-level socioeconomic factors, such as neighborhood disadvantage, are unclear. METHODS/STUDY POPULATION: We recruited two-hundred and fifteen traumatically-injured participants from an Emergency Department in southeastern Wisconsin. An Area Deprivation Index (ADI) score, a national measure of neighborhood socioeconomic disadvantage, was derived from each participant’s home address. Two-weeks post-trauma, participants underwent a battery of self-report measures and functional magnetic resonance imaging (fMRI) scans. Using a multi-modal approach, we investigated the impact of ADI on brain structure as well as neural activation during rest and during an emotional uncertainty task. We sought to disentangle the relationship between neighborhood and individual socioeconomic position and neural activity in the context of trauma. RESULTS/ANTICIPATED RESULTS: We demonstrated that neighborhood disadvantage is associated with decreased volume and alterations of resting state functional connectivity of structures implicated in affect processing, including the hippocampus, amygdala, and ventromedial prefrontal cortex. These results held even after controlling for relevant individual variables, including acute post-traumatic stress symptoms and years of education. Moreover, individuals from disadvantaged neighborhoods exhibited heighted activation of these same structures in response to aversive stimuli. Thus, brain regions critical for recognizing and processing negative stimuli are susceptible to the effects of area-level socioeconomic factors. DISCUSSION/SIGNIFICANCE OF FINDINGS: The results offer additional evidence that neurobiological mechanisms clarify how stress ‘gets under the skin’. Changes to key brain regions may explain why those living in disadvantaged neighborhoods are at a heighted risk of PTSD. Broadly, these findings should inform future policies and community-driven interventions aimed at reducing poverty.
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Berg, Kristen, Nikolas I. Krieger, Douglas Einstadter, Lorella Shamakian, Jarrod Dalton, and Adam Perzynski. "Neighborhood Disadvantage, Cognition, and Health Self-Efficacy of Older Adults in a Clinical Population." Innovation in Aging 4, Supplement_1 (December 1, 2020): 483–84. http://dx.doi.org/10.1093/geroni/igaa057.1563.
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Abstract The Medicare Annual Wellness Visit (MWV) includes an assessment of health risks for older adults in the United States. Research suggests that neighborhood-level social inequality influences multiple health outcomes. We sought to examine the association between neighborhood socioeconomic position and older adults’ cognition, health management self-efficacy, and other health risks. We identified a cohort of 12,434 adults aged 65 and over from the NEOCARE Learning Health Registry who attended a routine MWV between 2011 and 2019. NEOCARE includes electronic health record and neighborhood data from 1999-2017 on over 3 million unique Northeast Ohio individuals. The study population was 60% White, 32% Black or African American, 64% female, and 90% non-Hispanic. Over 60% were ages 65-74, 29% 75-84, and 10% 85 years or older (range from 65 to 101). We used ANOVA and chi square tests to examine variation in health risks by quintile of census tract area deprivation index. Cognitive functioning differed across quintiles of area deprivation and Bonferroni-corrected tests indicated that adults in the most socioeconomically disadvantaged neighborhoods had lower average cognitive screening scores as compared to older adults in less disadvantaged areas (F=53.50, df=4, n=12,204, p<.001). The proportion of adults feeling efficacious in managing their health differed according to area deprivation, with adults in more disadvantaged neighborhoods having slightly lower self-efficacy, (x2=11.01, df=8, n=11,937, p<.001). Better understanding of the relationship between cognitive functioning and health self-efficacy and neighborhood environment is critical for designing programmatic and policy interventions aimed at supporting proactive aging in older adulthood.
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Tao, Yinhua, Jie Yang, and Yanwei Chai. "The Anatomy of Health-Supportive Neighborhoods: A Multilevel Analysis of Built Environment, Perceived Disorder, Social Interaction and Mental Health in Beijing." International Journal of Environmental Research and Public Health 17, no. 1 (December 18, 2019): 13. http://dx.doi.org/10.3390/ijerph17010013.
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Mental health is an exceedingly prevalent concern for the urban population. Mounting evidence has confirmed the plausibility of high incidences of mental disorders in socioeconomically disadvantaged neighborhoods. However, the association between the neighborhood built environment and individual mental health is understudied and far from conclusive, especially in developing countries such as China. The underlying mechanism requires in-depth analysis combining potential intermediates such as perceived environmental disorder and supportive social relationships. Using a health survey conducted in Beijing in 2017, this study investigates for the first time a socio-environmental pathway through which perceived disorder and social interaction account for the relationship between the built environment and mental health under the very notion of the neighborhood effect. The results from multilevel structural equation models indicate that individual mental health is influenced by the neighborhood-scale built environment through three pathways, independent of neighborhood socioeconomic disadvantages: (1) proximity to parks is the sole indicator directly linked to mental health; (2) population density, road connectivity and proximity to parks are indirectly associated with mental health through interactions with neighbors; and (3) population density, road connectivity and facility diversity are partially associated with perceived neighborhood disorder, which is indirectly correlated with mental health through interactions with neighbors. This study is a preliminary attempt to disentangle the complex relationships among the neighborhood environment, social interaction and mental health in the context of developing megacities. The relevant findings provide an important reference for urban planners and administrators regarding how to build health-supportive neighborhoods and healthy cities.
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Islam, M., and Dennis Wollersheim. "Variation in Prescription Opioid Dispensing across Neighborhoods of Diverse Socioeconomic Disadvantages in Victoria, Australia." Pharmaceuticals 11, no. 4 (November 1, 2018): 116. http://dx.doi.org/10.3390/ph11040116.
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The study examined the relationship between dispensing patterns of prescription opioids, neighborhood-disadvantage-index, and standardized doses dispensed. Three-year’s dispensing data drawn from 80 local government areas (LGAs) within Victoria, Australia’s second most populous state, was analyzed. Quantities dispensed in defined daily dose (DDD)/1000-people/day were computed for LGAs of low, moderate, high, and very high socio-economic disadvantage. LGAs with various levels of dispensing, and neighborhood disadvantage were identified and mapped. A multivariable regression model examined the effect of neighborhood level disadvantage and identified other factors that are associated with standardized doses dispensed. More women were dispensed opioids than men. Dispensing increased with increasing age. Most of the LGAs with relatively high dispensing were socioeconomically disadvantaged and located outside the major cities. Dispensing gradually increased from low disadvantage to very high disadvantage areas. Dispensing of standardized doses were consistently higher in rural areas than in urban areas. Neighborhood level disadvantage, age, sex, and urbanization were significant factors in the standardized doses dispensed. As inappropriate dispensing of opioids is a major public health problem, research should facilitate understanding of utilization in small areas to enable tailored public health programs. Nationwide and consistent introduction of real-time prescription drug-monitoring programs, and structural interventions to reduce the fundamental causes of socioeconomic disadvantage and isolation are recommended.
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Ross, Catherine E., and John Mirowsky. "Neighborhood Socioeconomic Status and Health: Context or Composition?" City & Community 7, no. 2 (June 2008): 163–79. http://dx.doi.org/10.1111/j.1540-6040.2008.00251.x.
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Does neighborhood socioeconomic status (SES) have a significant positive effect on health over and above the personal and household socioeconomic status of the residents who live there, and, if it does, what is its relative importance compared to an individual's own SES? Resolution of this question has been impeded by lack of conceptual clarity in the definitions of socioeconomic status on the micro– and macro–levels, and unreliable and noncomprehensive adjustment for micro–level socioeconomic status. Using the Community, Crime and Health Survey (CCH), based on a representative sample of Illinois households with linked census tract information, we find that, with adjustment for personal socioeconomic status, residents of socioeconomically disadvantaged neighborhoods have significantly higher levels of physical impairment than do residents of more advantaged neighborhoods. The neighborhood effect is small compared to individual socioeconomic status, especially education, employment status, household income, and economic hardship, all of which have larger associations with health than does neighborhood socioeconomic status (measured as home ownership, college–educated adults, and poverty). in comparison, home ownership on the micro–level does not have a significant effect on physical functioning. We conclude that about 40 percent of the association between neighborhood socioeconomic status and individual health is contextual and about 60 percent is compositional.
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Olaya-Contreras, Patricia, Myriam Bastidas, and Daniel Arvidsson. "Colombian Children With Overweight and Obesity Need Additional Motivational Support at School to Perform Health-Enhancing Physical Activity." Journal of Physical Activity and Health 12, no. 5 (May 2015): 604–9. http://dx.doi.org/10.1123/jpah.2014-0024.
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Aims:The aim of this study is to investigate associations of screen-time and physical activity (PA) with self-efficacy for PA, intrinsic motivation to PA and health-related quality of life (HRQoL) in Colombian schoolchildren from socioeconomically disadvantaged neighborhoods, and to compare these variables among children with normal-weight (NW), overweight (OW) and obesity (OB).Methods:In 678 schoolchildren (age 10–14 years) screen-time (TV, video games, computer) and number of days being physically active ≥ 60 minutes were self-reported. Multi-item scales were used to assess self-efficacy to PA and intrinsic motivation to PA. The KIDSCREEN-27 was used to assess HRQoL.Results:Screen-time was associated with HRQoL in the school/learning environment dimension. Number of days being physically active was associated with self-efficacy for PA, intrinsic motivation for PA and with HRQoL concerning physical well-being, autonomy/parent relation and social support/peers. Group differences were found for days being physically active (OW = 2.8 and OB = 2.7 vs. NW = 3.3) but not for screen-time (NW = 5.0, OW = 4.7 and OB = 5.7 hrs·d-1). OW and OB scored lower on intrinsic motivation to PA than NW (OW = 19.2 and OB = 17.9 versus NW = 20.1). All 3 groups differed in physical well-being scores (NW = 50.3, OW = 48.1, OB = 40.6, P < .001).Conclusions:Schoolchildren with overweight and obesity from socioeconomically disadvantaged neighborhoods need additional motivational support to perform health-enhancing PA to experience higher physical well-being.
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Smith, Kylie J., Sarah A. McNaughton, Verity J. Cleland, David Crawford, and Kylie Ball. "Health, Behavioral, Cognitive, and Social Correlates of Breakfast Skipping among Women Living in Socioeconomically Disadvantaged Neighborhoods." Journal of Nutrition 143, no. 11 (August 28, 2013): 1774–84. http://dx.doi.org/10.3945/jn.113.181396.
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Lantos, Paul M., Gabriela Maradiaga-Panayotti, Xavier Barber, Eileen Raynor, Debara Tucci, Kate Hoffman, Sallie R. Permar, et al. "Geographic and Racial Disparities in Infant Hearing Loss." Otolaryngology–Head and Neck Surgery 159, no. 6 (October 9, 2018): 1051–57. http://dx.doi.org/10.1177/0194599818803305.
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Objective Approximately 1 to 2 of every 1000 American newborns has hearing loss identified by newborn screening. This study was designed to determine if infant hearing loss is more common in socioeconomically disadvantaged communities. Study Design In this retrospective study, we analyzed electronic medical record data using geostatistical models. Setting Infants were residents of Durham County, North Carolina, born in 2 hospitals of the Duke University Health System. This county includes the city of Durham and surrounding suburban and rural communities. Subjects and Methods Subjects were hearing-screened newborns, born between 2005 and 2016, whose residential address was in Durham County, North Carolina. This was a retrospective study using medical record data. We used Bayesian regression models with smoothing of coordinate date to identify both spatial and nonspatial predictors of infant hearing loss. Results We identified 19,348 infants from Durham County, of whom 675 had failed initial hearing screening and 191 had hearing loss confirmed on follow-up. Hearing loss was significantly associated with minority race (odds ratio [OR], 2.45; 95% confidence interval, 1.97-3.06), as well as lower gestational age and maternal sexually transmitted infections. We identified significant geographic heterogeneity, with a higher probability of hearing loss in poorer urban neighborhoods (local OR range, 0.59-1.39). Neighborhood disadvantage was a significant predictor of hearing loss, as was high local seroprevalence of cytomegalovirus (CMV) among pregnant women. Conclusions Urban, low-income neighborhoods have a high prevalence of infant hearing loss compared with more affluent surrounding communities, particularly among minorities. This distribution may be attributable to congenital CMV infection.
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Ellis, Rachel. "“It’s Not Equality”: How Race, Class, and Gender Construct the Normative Religious Self among Female Prisoners." Social Inclusion 6, no. 2 (June 22, 2018): 181–91. http://dx.doi.org/10.17645/si.v6i2.1367.
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Prior sociological research has demonstrated that religious selves are gendered. Using the case of female inmates—some of the most disadvantaged Americans—this article shows that dominant messages constructing the religious self are not only gendered, but also deeply intertwined with race and class. Data from 12 months of ethnographic fieldwork on religion inside a U.S. state women’s prison reveal that religious volunteers—predominately middle-class African American women—preached feminine submissiveness and finding a “man of God” to marry to embody religious ideals. However, these messages were largely out of sync with the realities of working class and poor incarcerated women, especially given their temporary isolation from the marriage market and the marital prospects in the socioeconomically disadvantaged neighborhoods to which many would return. These findings suggest that scholars must pay attention to how race, class, and gender define dominant discourses around the religious self and consider the implications for stratification for those who fail to fulfill this dominant ideology.
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Moschetti, Mauro C., and Carolina Snaider. "Speaking cooperation, acting competition: Supply-side subsidies and private schools in socioeconomically disadvantaged contexts in Buenos Aires." education policy analysis archives 27 (October 21, 2019): 131. http://dx.doi.org/10.14507/epaa.27.4330.
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Few studies have explored how schools respond to competition in socially embedded education quasi-markets. This study focuses on how state-subsidized privately-run low-fee schools (S-LFPSs) compete with free public schools in some of the poorest neighborhoods of the City of Buenos Aires. In particular, we explore how S-LFPSs follow different logics of action to attract (and shape) enrollment profiting from their extended autonomy and some regulatory gaps. We applied discourse analysis on data from eight months of ethnographic case study research in nine S-LFPSs. Student selection and operational changes (e.g., increasing the student/teacher ratio) prevail over academic and curricular changes. Selection is operated by means of aptitude tests and screening interviews, and other symbolic artifacts aimed at signaling differences with state-run schools and the potential fit between schools and families. We present a heuristic typology of the different logics of action systematizing the schools’ responses as their leading orientations toward the competitive environment. We suggest that policy inconsistencies and deficient governmental oversight tilt the field against state-run schools. Rather than ensuring equality of educational opportunity, the policy contributes to shape and deepen a highly segregated and inequitable educational landscape.
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Pollak, Miriam J., Catherine M. Milte, Paige van der Pligt, and Megan Teychenne. "Total physical activity but not diet quality associated with postnatal depressive symptoms amongst women living in socioeconomically disadvantaged neighborhoods." Nutrition Research 68 (August 2019): 54–61. http://dx.doi.org/10.1016/j.nutres.2019.05.009.
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Engel, Ilana J., and Tamara A. Baker. "THE INFLUENCE OF SOCIAL ISOLATION AND NEIGHBORHOOD DANGER ON OLDER ADULTS’ FUNCTIONAL STATUS." Innovation in Aging 3, Supplement_1 (November 2019): S529—S530. http://dx.doi.org/10.1093/geroni/igz038.1947.
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Abstract Social isolation is often associated with smaller social networks, bereavement, and chronic health problems. In addition, underserved neighborhoods, without the resources and social support of other areas, may further promote social isolation among older adults. This study utilized data from the 2nd wave of the nationally representative National Social Life, Health, and Aging Project (NSHAP) to examine if perceived neighborhood danger mediates the relationship between social isolation and functional impairment. We hypothesized that those who are less socially connected and feel less safe in their communities may experience worse health outcomes. Data for the total sample (N=1,804; 62-91 years of age) showed that partial mediation was supported, (F 2, 1801 = 22.91, p<0.01). Similar statistics were found by gender (men, F 2, 985 = 8.20, p<0.01; women, F 2, 813 = 14.79, p<0.01). This relationship, however, showed a stronger association among women (β = -.39, p<.01) than men (β = -.26, p<.05). Findings indicate that the relationship between perceived social isolation and impaired functional status may be partially explained by perceived neighborhood danger. These findings suggest that older adults who perceive their neighborhoods as dangerous, may be more socially isolated, and at risk for functional decline. These results support the Reserve Capacity Model, which posits that social resources are of increased importance for socioeconomically disadvantaged individuals. Additional research is needed to examine how such factors as stress, environment, and access to care contribute to our understanding of health outcomes among this population of adults.
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MacFarlane, Abbie, Gavin Abbott, David Crawford, and Kylie Ball. "Personal, social and environmental correlates of healthy weight status amongst mothers from socioeconomically disadvantaged neighborhoods: findings from the READI study." International Journal of Behavioral Nutrition and Physical Activity 7, no. 1 (2010): 23. http://dx.doi.org/10.1186/1479-5868-7-23.
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Ali, Shahmir H., Valerie M. Imbruce, Rienna G. Russo, Samuel Kaplan, Kaye Stevenson, Tamar Adjoian Mezzacca, Victoria Foster, et al. "Evaluating Closures of Fresh Fruit and Vegetable Vendors During the COVID-19 Pandemic: Methodology and Preliminary Results Using Omnidirectional Street View Imagery." JMIR Formative Research 5, no. 2 (February 18, 2021): e23870. http://dx.doi.org/10.2196/23870.
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Background The COVID-19 pandemic has significantly disrupted the food retail environment. However, its impact on fresh fruit and vegetable vendors remains unclear; these are often smaller, more community centered, and may lack the financial infrastructure to withstand supply and demand changes induced by such crises. Objective This study documents the methodology used to assess fresh fruit and vegetable vendor closures in New York City (NYC) following the start of the COVID-19 pandemic by using Google Street View, the new Apple Look Around database, and in-person checks. Methods In total, 6 NYC neighborhoods (in Manhattan and Brooklyn) were selected for analysis; these included two socioeconomically advantaged neighborhoods (Upper East Side, Park Slope), two socioeconomically disadvantaged neighborhoods (East Harlem, Brownsville), and two Chinese ethnic neighborhoods (Chinatown, Sunset Park). For each neighborhood, Google Street View was used to virtually walk down each street and identify vendors (stores, storefronts, street vendors, or wholesalers) that were open and active in 2019 (ie, both produce and vendor personnel were present at a location). Past vendor surveillance (when available) was used to guide these virtual walks. Each identified vendor was geotagged as a Google Maps pinpoint that research assistants then physically visited. Using the “notes” feature of Google Maps as a data collection tool, notes were made on which of three categories best described each vendor: (1) open, (2) open with a more limited setup (eg, certain sections of the vendor unit that were open and active in 2019 were missing or closed during in-person checks), or (3) closed/absent. Results Of the 135 open vendors identified in 2019 imagery data, 35% (n=47) were absent/closed and 10% (n=13) were open with more limited setups following the beginning of the COVID-19 pandemic. When comparing boroughs, 35% (28/80) of vendors in Manhattan were absent/closed, as were 35% (19/55) of vendors in Brooklyn. Although Google Street View was able to provide 2019 street view imagery data for most neighborhoods, Apple Look Around was required for 2019 imagery data for some areas of Park Slope. Past surveillance data helped to identify 3 additional established vendors in Chinatown that had been missed in street view imagery. The Google Maps “notes” feature was used by multiple research assistants simultaneously to rapidly collect observational data on mobile devices. Conclusions The methodology employed enabled the identification of closures in the fresh fruit and vegetable retail environment and can be used to assess closures in other contexts. The use of past baseline surveillance data to aid vendor identification was valuable for identifying vendors that may have been absent or visually obstructed in the street view imagery data. Data collection using Google Maps likewise has the potential to enhance the efficiency of fieldwork in future studies.
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Olstad, Dana Lee, Kylie Ball, Craig Wright, Gavin Abbott, Erin Brown, and Anne Isabella Turner. "Hair cortisol levels, perceived stress and body mass index in women and children living in socioeconomically disadvantaged neighborhoods: the READI study." Stress 19, no. 2 (March 3, 2016): 158–67. http://dx.doi.org/10.3109/10253890.2016.1160282.
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Gomes Jardim, Gabriel Behr, Armin von Gunten, Irenio Gomes da Silva Filho, Patricia Klarmann Ziegelmann, Daniela Benzano Bumaguin, Eduardo Lopes Nogueira, Paula Engroff, and Alfredo Cataldo Neto. "Relationship between childhood maltreatment and geriatric depression: the mediator effect of personality traits." International Psychogeriatrics 31, no. 12 (March 4, 2019): 1759–67. http://dx.doi.org/10.1017/s1041610219000073.
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ABSTRACTBackground:Childhood maltreatment is an important factor associated with adverse mental health outcomes including geriatric depression and the “big five” personality characteristics. The objective of this study was to evaluate a model where personality characteristics mediate the relationship between childhood maltreatment and geriatric depression.Method:In this cross-sectional study, elderly subjects from socioeconomically disadvantaged neighborhoods of Porto Alegre, Brazil (n = 260) completed the Childhood Trauma Questionnaire (CTQ), NEO-Five Factor Inventory (NEO-FFI), and Mini International Neuropsychiatric Interview 5.0 (MINI plus). We used structural equation modeling (SEM) to evaluate the mediation hypothesis.Results:The five personality factors (neuroticism, extraversion, agreeableness, openness, and conscientiousness) were related to childhood maltreatment and depression. Mediation analysis revealed that neuroticism and extraversion are complete mediators, agreeableness and conscientiousness are partial mediators, and openness is not a mediator.Conclusions:These findings support the hypothesis in which childhood maltreatment is associated with geriatric depression and mediated by personality factors. These results suggest that reducing the maladaptive personality trait in elderly people who suffered childhood maltreatment could prevent geriatric depression.
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Miller, Robin E. "Various Factors May Influence High School Student Use of Public Libraries." Evidence Based Library and Information Practice 8, no. 3 (September 10, 2013): 70. http://dx.doi.org/10.18438/b8pc95.
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Objective – To discover the factors that influence frequency of high school students’ usage of public libraries.
Design – Structural equation modeling (SEM) using the person-in-environment (PIE) framework to test latent variables and direct and indirect relationships between variables.
Setting – Public and school libraries in the United States.
Subjects – Three datasets: Educational Longitudinal Study of 2002, the National Center for Education Statistics (NCES), provides data about individual students; Public Libraries Survey of 2004, then conducted by NCES, provides data about public libraries in the United States; and Summary Files 1 and 3 of U.S. Census 2000, provide neighborhood-level demographic data.
Methods – Using ArcGIS, the researcher prepared and linked three datasets. Data were analyzed using factor analysis, regression, weighted least squares, and path analysis in order to test relationships between variables exposed in three large datasets.
Main Results – Frequency of public library use by high school students may be influenced by several factors, including race and/or ethnicity and access to resources like school libraries, home computers, and public libraries with adequate service levels.
Conclusion – Increased funding for public library spaces and resources may be warranted by the finding that high levels of public library service may increase high school students’ use of public libraries, particularly in socioeconomically disadvantaged neighborhoods.
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Melotte, Sara, and Mayank Kejriwal. "A Geo-Tagged COVID-19 Twitter Dataset for 10 North American Metropolitan Areas over a 255-Day Period." Data 6, no. 6 (June 16, 2021): 64. http://dx.doi.org/10.3390/data6060064.
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One of the unfortunate findings from the ongoing COVID-19 crisis is the disproportionate impact the crisis has had on people and communities who were already socioeconomically disadvantaged. It has, however, been difficult to study this issue at scale and in greater detail using social media platforms like Twitter. Several COVID-19 Twitter datasets have been released, but they have very broad scope, both topically and geographically. In this paper, we present a more controlled and compact dataset that can be used to answer a range of potential research questions (especially pertaining to computational social science) without requiring extensive preprocessing or tweet-hydration from the earlier datasets. The proposed dataset comprises tens of thousands of geotagged (and in many cases, reverse-geocoded) tweets originally collected over a 255-day period in 2020 over 10 metropolitan areas in North America. Since there are socioeconomic disparities within these cities (sometimes to an extreme extent, as witnessed in ‘inner city neighborhoods’ in some of these cities), the dataset can be used to assess such socioeconomic disparities from a social media lens, in addition to comparing and contrasting behavior across cities.
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Gorey, Kevin M., Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, and Eric J. Holowaty. "Breast Cancer Care in California and Ontario: Primary Care Protections Greatest Among the Most Socioeconomically Vulnerable Women Living in the Most Underserved Places." Journal of Primary Care & Community Health 8, no. 3 (January 9, 2017): 127–34. http://dx.doi.org/10.1177/2150131916686284.
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Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation therapy. Results: Women in Ontario received more optimal care in communities well supplied by primary care physicians. They were particularly advantaged in the most disadvantaged places: high poverty neighborhoods (rate ratio = 1.65) and communities lacking specialist physicians (rate ratio = 1.33). Canadian advantages were explained by better health insurance coverage and greater primary care access. Conclusions: Policy makers ought to ensure that the newly insured are adequately insured. The Medicaid program should be expanded, as intended, across all 50 states. Strengthening America’s system of primary care will probably be the best way to ensure that the Affordable Care Act’s full benefits are realized.
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Smokowski, Paul R., Shenyang Guo, Roderick Rose, Caroline B. R. Evans, Katie L. Cotter, and Martica Bacallao. "Multilevel risk factors and developmental assets for internalizing symptoms and self-esteem in disadvantaged adolescents: Modeling longitudinal trajectories from the Rural Adaptation Project." Development and Psychopathology 26, no. 4pt2 (November 2014): 1495–513. http://dx.doi.org/10.1017/s0954579414001163.
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AbstractThe current study filled significant gaps in our knowledge of developmental psychopathology by examining the influence of multilevel risk factors and developmental assets on longitudinal trajectories of internalizing symptoms and self-esteem in an exceptionally culturally diverse sample of rural adolescents. Integrating ecological and social capital theories, we explored if positive microsystem transactions are associated with self-esteem while negative microsystem transactions increase the chances of internalizing problems. Data came from the Rural Adaptation Project, a 5-year longitudinal panel study of more than 4,000 middle school students from 28 public schools in two rural, disadvantaged counties in North Carolina. Three-level hierarchical linear modeling models were estimated to predict internalizing symptoms (e.g., depression, anxiety) and self-esteem. Relative to other students, risk for internalizing problems and low self-esteem was elevated for aggressive adolescents, students who were hassled or bullied at school, and those who were rejected by peers or in conflict with their parents. Internalizing problems were also more common among adolescents from socioeconomically disadvantaged families and neighborhoods, among those in schools with more suspensions, in students who reported being pressured by peers, and in youth who required more teacher support. It is likely that these experiences left adolescents disengaged from developing social capital from ecological microsystems (e.g., family, school, peers). On the positive side, support from parents and friends and optimism about the future were key assets associated with lower internalizing symptoms and higher self-esteem. Self-esteem was also positively related to religious orientation, school satisfaction, and future optimism. These variables show active engagement with ecological microsystems. The implications and limitations were discussed.
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Witherspoon, Dawn P., Deborah Rivas-Drake, and Meeta Banerjee. "It’s More the Exception Rather Than the Rule: African American Families’ Neighborhoods and Youth’s Academic Performance During Middle School." Journal of Black Psychology 44, no. 6 (September 2018): 562–88. http://dx.doi.org/10.1177/0095798418806130.
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Neighborhoods are an important part of the social milieu of adolescence and academic performance. Using experiential neighborhood profiles, this study examined risks and assets to determine how neighborhood structural and relational dynamics were associated with academic achievement during early adolescence. The sample included 723 African American socioeconomically diverse families ( Myouth age = 12.27 years, SD = 0.55). Results showed that neighborhood structural disadvantage was unrelated to academic achievement, whereas neighborhood profiles were associated with academic performance in eighth grade, after adjusting for seventh grade GPA. Neighborhood profiles characterized by positive social relationships were associated with higher achievement. Authors discuss the importance of examining neighborhood risks and supports for African American youth’s academic adjustment.
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Kravitz-Wirtz, Nicole. "Cumulative Effects of Growing Up in Separate and Unequal Neighborhoods on Racial Disparities in Self-rated Health in Early Adulthood." Journal of Health and Social Behavior 57, no. 4 (November 1, 2016): 453–70. http://dx.doi.org/10.1177/0022146516671568.
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Evidence suggests that living in a socioeconomically deprived neighborhood is associated with worse health. Yet most research relies on cross-sectional data, which implicitly ignore variation in longer-term exposure that may be more consequential for health. Using data from the 1970 to 2011 waves of the Panel Study of Income Dynamics merged with census data on respondents’ neighborhoods (N = 1,757), this study estimates a marginal structural model with inverse probability of treatment and censoring weights to examine: (1) whether cumulative exposure to neighborhood disadvantage from birth through age 17 affects self-rated health in early adulthood, and (2) the extent to which variation in such exposure helps to explain racial disparities therein. Findings reveal that prolonged exposure to neighborhood disadvantage throughout childhood and adolescence is strikingly more common among nonwhite versus white respondents and is associated with significantly greater odds of experiencing an incidence of fair or poor health in early adulthood.
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Elovainio, Marko, Jussi Vahtera, Jaana Pentti, Christian Hakulinen, Laura Pulkki-Råback, Jari Lipsanen, Marianna Virtanen, et al. "The Contribution of Neighborhood Socioeconomic Disadvantage to Depressive Symptoms Over the Course of Adult Life: A 32-Year Prospective Cohort Study." American Journal of Epidemiology 189, no. 7 (April 2, 2020): 679–89. http://dx.doi.org/10.1093/aje/kwaa026.
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Abstract The association between socioeconomic disadvantage and increased risk of depressive symptoms in adulthood is well established. We tested 1) the contribution of early exposure to neighborhood socioeconomic disadvantage to later depressive symptoms throughout life, 2) the persistence of the potential association between early exposure and depressive symptoms, and 3) the contributions of other known risk factors to the association. Data were collected from the Young Finns Study, a prospective, population-based 32-year follow-up study that included participants aged 3–18 years at baseline in 1980. Participants were followed up with repeated measurements of depressive symptoms between 1992 and 2012 (n = 2,788) and linked to national grid data on neighborhood disadvantage via residential addresses. We examined the associations in mixed models separately for the 5-, 10-, 15-, and 20-year follow-ups. Living in a disadvantaged neighborhood during childhood and adolescence was associated with a higher level of depressive symptoms in adulthood during all follow-up periods (β = 0.07, P = 0.001) than living in a nondisadvantaged area. Individual adulthood socioeconomic status mediated the associations. These findings suggest that living in a socioeconomically disadvantaged area during childhood and adolescence has a long-lasting negative association with mental health irrespective of family-related risks, partially due to socioeconomic adversity later in life.
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Hosokawa, Rikuya, and Toshiki Katsura. "The Relationship between Neighborhood Environment and Child Mental Health in Japanese Elementary School Students." International Journal of Environmental Research and Public Health 17, no. 15 (July 29, 2020): 5491. http://dx.doi.org/10.3390/ijerph17155491.
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Limited research has examined the relationship between neighborhood environment and mental health outcomes in elementary school students (middle childhood). In countries with high relative poverty, little is known about how neighborhood conditions are related to children’s health after controlling for family socioeconomic status; thus, it is necessary to distinguish the particular neighborhood characteristics relevant to behavioral risk in children, independent of socioeconomic position. Using a self-report survey completed by parents, we assessed neighborhood environment characteristics, children’s behavioral outcomes, and family socioeconomic status in fourth grade students from Nagoya, in Aichi prefecture, Japan (n = 695). A multiple linear regression was conducted to evaluate to what extent neighborhood characteristics predict child behaviors, after adjusting for socioeconomic variables. Greater aesthetic quality, walkability, accessibility of healthy foods, safety, and social cohesion were inversely linked to children’s behavioral problems and positively linked to social competence, suggesting that quality of living environment may affect behavioral outcomes in children, even after controlling for socioeconomic factors. Developing a quality environment that matches these characteristics may minimize the negative impact of a family’s socioeconomic distress and is likely to aid socioeconomically disadvantaged parents and their children. Thus, policies and programs that enhance the neighborhood environment for socioeconomically disadvantaged families should be promoted.
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Choi, Jeong-Kyun, Megan S. Kelley, and Dan Wang. "Neighborhood Characteristics, Maternal Parenting, and Health and Development of Children from Socioeconomically Disadvantaged Families." American Journal of Community Psychology 62, no. 3-4 (September 21, 2018): 476–91. http://dx.doi.org/10.1002/ajcp.12276.
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Brown, Kevin J., and Frederick D. Weil. "Strangers in the Neighborhood: Violence and Neighborhood Boundaries." Journal of Contemporary Ethnography 49, no. 1 (July 3, 2019): 86–117. http://dx.doi.org/10.1177/0891241619857150.
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New Orleans experienced elevated rates of violent crime throughout the thirty years between 1985 and 2015. Violence was disproportionately represented in socioeconomically disadvantaged communities. This study explores the lived experiences of residents from one such neighborhood, using individual interviews, focus groups, and participant observation. The data indicate that neighborhood boundaries vacillated between rigidly defensive and porous, which impacted residents’ ability to enact collective efficacy and thus to create a milieu that either positively or negatively influenced the likelihood of violence. With a long history of institutional and social neglect, the community initially viewed outsiders as invaders which resulted in rigidly defended boundaries. As the community emerged from social marginalization and was able to enact collective efficacy, its boundaries became more porous and resources flowed into the community. As a result, violence decreased, further enhancing collective efficacy and boundary porosity in a virtuous cycle. This suggests that crime prevention and response models that engage residents and decrease marginalization may decrease cynicism, open boundaries, and improve collective efficacy, thereby reducing neighborhood violence.
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Okoye, Safiyyah M., Nancy Perrin, Sarah Szanton, and Adam P. Spira. "EXTERNAL HOME DISREPAIR ASSOCIATED WITH OBJECTIVE SLEEP DISTURBANCES IN LOW-INCOME OLDER ADULTS WITH DISABILITIES." Innovation in Aging 3, Supplement_1 (November 2019): S922. http://dx.doi.org/10.1093/geroni/igz038.3358.
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Abstract Sleep disturbances are linked to poor health, loss of independence and mortality in older adults. Rates of poor sleep are higher among socioeconomically disadvantaged older adults. Understanding how environmental factors may affect sleep in this population could lead to interventions to improve sleep-related health outcomes. We determined cross-sectional associations of home and neighborhood conditions with sleep parameters, measured by wrist actigraphy, in 136 low-income, predominantly African-American older adults with disabilities. Primary predictors were third-party-rated objective indicators of disrepair or disorder based on: 1) inside-home conditions (e.g., evidence of pests, tripping hazards, clutter); 2) outside-home conditions (e.g., broken windows, crumbling foundation); and 3) neighborhood conditions (e.g., litter, graffiti, vacant buildings). Outcomes were actigraphic total sleep time (TST; total number of minutes in bed spent asleep), wake time after sleep onset (WASO; total number of minutes spent awake after initially falling asleep), and sleep efficiency (SE; % of time in bed spent asleep). Presence of one or more outside-home conditions indicating disrepair or disorder was associated with 36.3-minutes shorter TST, 18.1-minutes more WASO, and 4.7% lower SE (all p <0.05). Conditions inside the home and of the neighborhood were not associated with sleep. These preliminary findings suggest that among low-income older adults with disabilities, external-home disrepair is associated with objectively measured WASO, TST, and SE. External-home disrepair may affect sleep through physical, psychosocial and behavioral pathways. Further research should examine longitudinal associations between external-home conditions and objectively measured sleep in socioeconomically disadvantaged older adults.
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Saban, Yakup, Bülent Aydoğdu, and Rıdvan Elmas. "ACHIEVEMENT AND GENDER EFFECTS ON 5TH GRADER'S ACQUISITION OF SCIENCE PROCESS SKILLS IN A SOCIOECONOMICALLY DISADVANTAGED NEIGHBORHOOD." Journal of Baltic Science Education 18, no. 4 (August 3, 2019): 607–19. http://dx.doi.org/10.33225/jbse/19.18.607.
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Science process skills (SPSs) play a significant role in science education. This research aimed to determine the acquisition level of 5th-grade students in SPSs with classroom activities. The research was a case study, and the data were collected by focus group interviews, document analysis, and observations. The sample of the research was six students from the fifth grade selected based on maximum variation sampling. Science process skills focused worksheets, focus group interview schedule, and observation forms were used as data collection tools. As a result, it was found out that the students were at the average or above the average level in observing, predicting, measuring, comparing and classifying skills; and they were at below the average level in inferring, organizing data, identifying and using experimental materials, processing data and formulating models, controlling variables, experimenting, interpreting and inferring. Also, it was determined that students with high academic achievement have more acquisition in SPSs. Besides, it was found out that the development of SPSs is gender neutral, it depends on the number of activities that are made in the classroom and what is the role of the students in these activities. Keywords: gender in science process skills, lower secondary school, science achievement, science activities, science process skills.
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Barber, Sharrelle, DeMarc A. Hickson, Ichiro Kawachi, S. V. Subramanian, and Felton Earls. "Neighborhood Disadvantage and Cumulative Biological Risk Among a Socioeconomically Diverse Sample of African American Adults: An Examination in the Jackson Heart Study." Journal of Racial and Ethnic Health Disparities 3, no. 3 (September 28, 2015): 444–56. http://dx.doi.org/10.1007/s40615-015-0157-0.
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Li, Wangyang, Minyi Li, Yongai Jin, Shiqi Wang, and Yi Zhang. "Double Jeopardy in Contemporary China: Intersecting the Socioeconomic Gradient and Geographic Context on Early Childhood Development." International Journal of Environmental Research and Public Health 17, no. 14 (July 8, 2020): 4937. http://dx.doi.org/10.3390/ijerph17144937.
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Family socioeconomic status (SES) differences in early childhood development (ECD) are well documented, as are the neighborhood effects in early development outcomes. However, little is known about whether the SES gradient in ECD outcomes varies across geographic contexts by county-level variables in contemporary China. This study examines the effects of county-level socioeconomic background on inequalities in the developmental outcomes of young Chinese children. Individual-level child development data based on four early development milestones—taking a first step, first sentences, counting 10 objects, fully independent toileting—were combined with family- and county-level socioeconomic data from the China Family Panel Studies (CFPS). Using a hierarchical linear model (HLM) to examine how the broader socioeconomic context plays a role in the attainment of developmental milestones at expected times as young children grow and develop, we have found significant cross-level interaction effects between family SES and county-level variables in relation to developmental milestone attainment. The family SES gradient in the achievement of children’s developmental milestones is steeper for those in the under-developed regions than their counterparts in the more developed regions. Our findings suggest that low-SES children who are living in socioeconomically deprived regions suffer from a double disadvantage in terms of early development outcomes. Further research would be needed to contextualize the observed interactions and better explain the underlying mechanisms.
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Ellison, Katherine, James Hill, Mona Fouad, Judy Vann, and R. Drew Sayer. "Nutrition Education, Hands-on Cooking and Financial Incentives to Change Purchasing Behaviors in a Low Socioeconomic Status Population: A Community-Based Study Protocol." Current Developments in Nutrition 5, Supplement_2 (June 2021): 1274. http://dx.doi.org/10.1093/cdn/nzab057_004.
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Abstract Objectives Socioeconomically disadvantaged populations are more likely to have both low nutrition literacy and low cooking efficacy. This combination often results in a high consumption of convenience foods that are typically energy-dense, nutrient poor, and promote the development or exacerbation of chronic disease. The objective of this study is to examine the effect of nutrition education, hands-on cooking practices, and financial incentives on grocery purchasing behaviors and diet quality in a low-income community. Methods Forty participants will receive nutrition education and hands-on cooking experiences through a 10-week nutrition education program via Zoom. An instructor will teach participants a nutrition topic and then prepare and cook a related meal with them. Participants will be notified of the recipe prior to class, and required foods will be provided for those participants who are unable to afford them. Participants will also receive discounts on food items labeled as “Live HealthSmart Foods” (LHS) at the Village Market grocery store in the East Lake neighborhood of Birmingham, Alabama. LHS foods include fresh, frozen or canned fruits and vegetables, whole grains, lean proteins, and low-fat or fat-free dairy products. Participants will use a unique pin code to receive the discount and their account will be examined for trends in their shopping behaviors. Main outcomes of interest include proportion of LHS foods purchased, dietary intake measured by a food frequency questionnaire and changes in nutrition literacy and cooking efficacy. Results Study results will indicate 1) if there is a synergistic effect of nutrition education, hands-on cooking practices, and financial incentives on grocery purchasing behaviors and 2) how the intervention influences diet quality. Conclusions Results will also inform our endeavor of expanding the territory of the Live HealthSmart food model in a randomized community-based trial investigating the intervention's potential for translation and implementation in a wider and more diverse community setting. Funding Sources This work was supported by the Live HealthSmart Alabama initiative, the Cooking Well nutrition program, Village Market, Albert Schweitzer Fellowship and the University of Alabama at Birmingham.
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Meij, Karuna R. M., Caroline Kooij, Mireille N. Bekker, Robert‐Jan H. Galjaard, and Lidewij Henneman. "Non‐invasive prenatal test uptake in socioeconomically disadvantaged neighborhoods." Prenatal Diagnosis, September 14, 2021. http://dx.doi.org/10.1002/pd.6043.
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De Ridder, David, José Sandoval, Nicolas Vuilleumier, Andrew S. Azman, Silvia Stringhini, Laurent Kaiser, Stéphane Joost, and Idris Guessous. "Socioeconomically Disadvantaged Neighborhoods Face Increased Persistence of SARS-CoV-2 Clusters." Frontiers in Public Health 8 (January 27, 2021). http://dx.doi.org/10.3389/fpubh.2020.626090.
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Objective: To investigate the association between socioeconomic deprivation and the persistence of SARS-CoV-2 clusters.Methods: We analyzed 3,355 SARS-CoV-2 positive test results in the state of Geneva (Switzerland) from February 26 to April 30, 2020. We used a spatiotemporal cluster detection algorithm to monitor SARS-CoV-2 transmission dynamics and defined spatial cluster persistence as the time in days from emergence to disappearance. Using spatial cluster persistence measured outcome and a deprivation index based on neighborhood-level census socioeconomic data, stratified survival functions were estimated using the Kaplan-Meier estimator. Population density adjusted Cox proportional hazards (PH) regression models were then used to examine the association between neighborhood socioeconomic deprivation and persistence of SARS-CoV-2 clusters.Results: SARS-CoV-2 clusters persisted significantly longer in socioeconomically disadvantaged neighborhoods. In the Cox PH model, the standardized deprivation index was associated with an increased spatial cluster persistence (hazard ratio [HR], 1.43 [95% CI, 1.28–1.59]). The adjusted tercile-specific deprivation index HR was 1.82 [95% CI, 1.56–2.17].Conclusions: The increased risk of infection of disadvantaged individuals may also be due to the persistence of community transmission. These findings further highlight the need for interventions mitigating inequalities in the risk of SARS-CoV-2 infection and thus, of serious illness and mortality.
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Won, Jongho. "Exploring Spatial Clustering Over Time and Spillover Effects of the Low-Income Housing Tax Credit on Neighborhood-Level Income Segregation." Urban Affairs Review, November 20, 2020, 107808742097343. http://dx.doi.org/10.1177/1078087420973436.
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This study investigates the longitudinal and spatial patterns and spillover effects of Low-Income Housing Tax Credit (LIHTC) developments on neighborhood-level income segregation. Focusing on all MSAs in the U.S., the results show that LIHTC units have been spatially clustered in socioeconomically disadvantaged neighborhoods over time. This research also explores the spillover effects of LIHTC units on neighborhood economic status by utilizing propensity scores and weighted linear regression to address a self-selection bias of developers’ decisions regarding the location of LIHTC projects. The results suggest that LIHTC developments, in general, are expected to increase the concentration of households that have lower income than the average household income of the MSA. However, in high-poverty neighborhoods, LIHTC developments yield positive spillover effects on neighborhood economic status. Moreover, providing LIHTC units in high-poverty neighborhoods where LIHTC units were built previously in the focal or any adjacent neighborhood also improves neighborhood economic status.
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Jiang, Yanping, Xiaoming Li, Hyunsan Cho, Monique J. Brown, Shan Qiao, and Mohammad R. Haider. "Effects of individual and neighborhood socioeconomic status on antiretroviral therapy adherence: The role of adherence self-efficacy." Journal of Health Psychology, August 16, 2019, 135910531986980. http://dx.doi.org/10.1177/1359105319869809.
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This study aimed to examine the potential mediation effect of adherence self-efficacy on the associations between individual and neighborhood socioeconomic status and antiretroviral therapy adherence in a sample of 337 people living with HIV in South Carolina, United States. Results showed that there were no direct effects of individual or neighborhood socioeconomic status on antiretroviral therapy adherence, whereas both individual socioeconomic status and neighborhood socioeconomic status were associated with adherence self-efficacy, which in turn were related to antiretroviral therapy adherence. These findings suggest that interventions targeting adherence self-efficacy may improve antiretroviral therapy adherence among people living with HIV with low socioeconomic status or those living in socioeconomically disadvantaged neighborhoods.
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Palta, Priya, Mehul Patel, Michael Griswold, Anna Kucharska-Newton, Beverly G. Windham, Michelle L. Snyder, Benjamin Capistrant, and Gerardo Heiss. "Abstract P279: Neighborhood Socioeconomic Status and Physical Function in Late Life: The Atherosclerosis Risk in Communities (ARIC) Study." Circulation 131, suppl_1 (March 10, 2015). http://dx.doi.org/10.1161/circ.131.suppl_1.p279.
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Introduction: Functional impairments influence the performance of activities of daily living and may result in dependence on others for basic self-care needs. Lower individual-level socioeconomic status (SES) is associated with more self-reported disability and lower measured walking speeds which convey a higher risk of cardiovascular and all-cause mortality. The role of neighborhood-level SES on these functional outcomes has not been widely examined. Hypothesis: We hypothesized that residing in a socioeconomically disadvantaged neighborhood is inversely associated with physical function, after accounting for individual-level SES. Methods: We included 5,388 participants (42% male, 19% black, mean age: 76 years) from the 2011-2013 examination of the ARIC cohort. Neighborhood SES was constructed from census-tract data and an index score was derived based on aggregate z-score estimates from the following 6 dimensions: median household income; median value of owner-occupied units; % adults with a high school degree; % adults with a college degree; % households receiving interest, dividend or rental income; and % adults employed in executive, managerial or professional occupations. Race-specific tertiles were generated to indicate low, middle and high neighborhood SES. The Short Physical Performance Battery (SPPB) was used to derive a summary score (0-12) of physical function based on the individual’s performance on gait speed, chair stands and balance exercises. Negative binomial regression was used to quantify the difference in the log of expected counts in the SPPB score between race-stratified low, middle and high neighborhood SES, adjusting for age, sex, body mass index (BMI), smoking, hypertension, diabetes, study center, and education as a measure of individual-level SES. The multivariable-adjusted effect of neighborhood SES on a 4-meter walking speed test and on grip strength was estimated by least-squares regression. Results: Blacks had a slower walking speed, higher grip strength and lower SPPB score compared to whites. Hypertension, higher BMI, and lower education were more prevalent among white and black individuals from low SES neighborhoods, compared to those from high SES neighborhoods. White participants residing in a low SES neighborhood had a 1.1 kilogram (95% CI: 0.3, 1.9) greater grip strength compared to those residing in high SES neighborhoods. Neighborhood SES was not associated with walking speed and SPPB in either whites or blacks. Associations were robust to adjustment for education. Conclusions: Individual but not neighborhood-level SES was associated with poorer physical function. The prevalence of adverse clinical comorbidities was higher among both black and white participants living in disadvantaged neighborhoods. Poorer individual, modifiable health and SES measures may be targets for interventions to reduce functional disparities.
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Corona, Gabrielle, Wendy M. Troxel, Tamara Dubowitz, and Tiffany Gary-Webb. "Abstract P283: Where You Shop and Neighborhood Access to Fruit and Vegetables are Associated With Self-rated and Cardiometabolic Health." Circulation 141, Suppl_1 (March 3, 2020). http://dx.doi.org/10.1161/circ.141.suppl_1.p283.
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Introduction: The food environment, including food retail venues, has been shown to be associated with diet, and many disadvantaged neighborhoods lack access to high quality and affordable healthy foods. Research has sought to understand whether and how the food retail environment influences diet, and it is possible that shopping at different types of stores (e.g. full-service vs discount grocery store) influences diet and self-reported health outcomes. There is limited understanding of whether factors of the food environment and primary shopping location impact cardiometabolic health (blood pressure, HbA1c, cholesterol) and self-rated health. Methods: We report on 459 individuals who participated in a blood draw in 2018 as part of the Pittsburgh Hill/Homewood Research on Eating, Shopping, and Health, a longitudinal natural-experiment study among African American adults from two socioeconomically similar neighborhoods. Participants reported their perceived access to fruit and vegetables within their neighborhood and where they did their primary food shopping. Outcomes include measured height, weight, blood pressure, cholesterol (HDL, Total), HbA1c, and participant’s self-rated health. We employed logistic regression to examine associations between 1) perceived fruit and vegetable availability, quality, and price and 2) primary food shopping store type and reason for shopping there, with cardiometabolic and self-rated health outcomes. Covariates were neighborhood, years lived in neighborhood, age, race, income, education, and marital status. Results: Participants were on average, 60.7 years old (SD=13.9); 81.7% (375 of 459) female; 80.4% (369 of 459) overweight/obese. After covariate adjustment, both more perceived accessibility of purchasing (OR: 0.47, 95% CI: 0.28, 0.79) and pricing of fruits and vegetables (OR: 0.59, 95% CI: 0.36, 0.96) within one’s neighborhood were associated with lower odds of high blood pressure. More accessible purchasing (OR: 0.59, 95% CI: 0.39, 0.90), pricing (OR: 0.62, 95% CI: 0.41, 0.94), and higher quality of fruits and vegetables (OR: 0.64, 95% CI: 0.42, 0.97) within one’s neighborhood were associated with lower odds of poor self-rated health. Doing one’s primary food shopping at a discount grocery store compared to a full-service grocery store was associated with lower odds of being overweight (OR: 0.51, 95% CI: 0.26, 0.99). Choosing a primary food store based on price rather than quality of food was associated with increased odds of high cholesterol (OR: 2.02, 95% CI: 1.19, 3.45). Conclusion: These results suggest that higher perceptions of access to fruits and vegetables in one’s neighborhood and choice of primary food shopping store are important correlates of cardiometabolic health. Further research should look towards understanding how direct food choices made at stores impact cardiometabolic outcomes within this population.
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Zhou, Shuo, Arnold H. Levinson, Xuhong Zhang, Jennifer D. Portz, Susan L. Moore, M. Odette Gore, Kelsey L. Ford, Qing Li, and Sheana Bull. "A Pilot Study and Ecological Model of Smoking Cues to Inform Mobile Health Strategies for Quitting Among Low-Income Smokers." Health Promotion Practice, July 23, 2020, 152483992094221. http://dx.doi.org/10.1177/1524839920942214.
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One crucial factor that leads to disparities in smoking cessation between groups with higher and lower socioeconomic status is more prevalent socioenvironmental smoking cues in low-income communities. Little is known about how these cues influence socioeconomically disadvantaged smokers in real-world scenarios and how to design interventions, especially mobile phone–based interventions, to counteract the impacts of various types of smoking cues. We interviewed 15 current smokers living in low-income communities and scanned their neighborhoods to explore smoking-related experiences and identify multilevel cues that may trigger them to smoke. Findings suggest four major types of smoking cues influence low-income smokers—internal, habitual, social, and environmental. We propose an ecological model of smoking cues to inform the design of mobile health (mHealth) interventions for smoking cessation. We suggest that user-triggered strategies will be most useful to address internal cues; server-triggered strategies will be most suitable in changing perceived social norms of smoking and routine smoking activities to address social and habitual cues; and context-triggered strategies will be most effective for counteracting environmental cues. The pros and cons of each approach are discussed regarding their cost-effectiveness, the potential to provide personalized assistance, and scale.
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Roth, Gregory, Rose Gabert, Blake Thomson, and Emmanuela Gakidou. "Abstract 15: Assessing Clinical Quality Indicators for Diabetes Care by Patient Home Zip Code." Circulation: Cardiovascular Quality and Outcomes 8, suppl_2 (May 2015). http://dx.doi.org/10.1161/circoutcomes.8.suppl_2.15.
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Objective: Quality of care for diabetes varies widely in the United States but is usually compared at the level of health facilities. As part of the HealthRise project, we analyzed ambulatory clinic data at the level of each patient’s residential zip code to determine whether achievement of risk factor targets is also a function of home neighborhood. Methods: Minnesota Community Measurement (MNCM) collects comprehensive patient-level clinical data from all non-federal ambulatory clinics in their state. Using MNCM data from the year 2013, we assessed risk factor targets for diabetes, defined as the percentage of adult diabetics seen at least twice in 12 months who achieved all of four risk factor targets (HbA1c < 8%, LDL<100 mg/dL, systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg, and documented to be free of tobacco use). We aggregated the data to the zip code in which the patient resided for Hennepin, Ramsey, and Rice Counties, representing Minneapolis-St. Paul and a nearby rural county. Results: Success in meeting the HbA1c target was similar between counties, with 74.1% of patients in Hennepin, 74.4% in Ramsey, and 76.2% in Rice meeting the target. However, this varied widely at the zip code level. Across zip codes, the HbA1c target was achieved by 58.8% to 90.0% of patients and the LDL target by 46.7% to 83.6% of patients. Blood pressure and tobacco use targets were met by more patients (74.4% to 95.3% for blood pressure and 70.2% to 94.6% for tobacco). The lowest-performing zip codes were consistent across all four targets. Populations with the lowest achievement levels were found in the neighborhoods of North Minneapolis and Camden in Hennepin County, Downtown St. Paul, Southwest Downtown St. Paul, and South East Downton St. Paul in Ramsay County, and outlying rural areas in Rice County. Conclusion: Small-area geographies based on residential zip code appear to stratify the achievement of risk factor targets for diabetic patients in Hennepin, Ramsey and Rice Counties. Patients living in socioeconomically disadvantaged areas are less likely to achieve these clinical targets. Policies to improve cardiovascular risk factor control within clinics should also consider expanding their data collection to include the role of patients’ neighborhood environment.
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Johnson, Amber E., Jianhui Zhu, William Garrard, Floyd W. Thoma, Suresh Mulukutla, Kiarri N. Kershaw, and Jared W. Magnani. "Area Deprivation Index and Cardiac Readmissions: Evaluating Risk‐Prediction in an Electronic Health Record." Journal of the American Heart Association 10, no. 13 (July 6, 2021). http://dx.doi.org/10.1161/jaha.120.020466.
Full textAbstract:
Background Assessment of the social determinants of post‐hospital cardiac care is needed. We examined the association and predictive ability of neighborhood‐level determinants (area deprivation index, ADI), readmission risk, and mortality for heart failure, myocardial ischemia, and atrial fibrillation. Methods and Results Using a retrospective (January 1, 2011–December 31, 2018) analysis of a large healthcare system, we assess the predictive ability of ADI on 30‐day and 1‐year readmission and mortality following hospitalization. Cox proportional hazards models analyzed time‐to‐event. Log rank analyses determined survival. C‐statistic and net reclassification index determined the model’s discriminative power. Covariates included age, sex, race, comorbidity, number of medications, length of stay, and insurance. The cohort (n=27 694) had a median follow‐up of 46.5 months. There were 14 469 (52.2%) men and 25 219 White (91.1%) patients. Patients in the highest ADI quintile (versus lowest) were more likely to be admitted within 1 year of index heart failure admission (hazard ratio [HR], 1.25; 95% CI, 1.03‒1.51). Patients with myocardial ischemia in the highest ADI quintile were twice as likely to be readmitted at 1 year (HR, 2.04; 95% CI, 1.44‒2.91]). Patients with atrial fibrillation living in areas with highest ADI were less likely to be admitted within 1 year (HR, 0.79; 95% CI, 0.65‒0.95). As ADI increased, risk of readmission increased, and risk reclassification was improved with ADI in the models. Patients in the highest ADI quintile were 25% more likely to die within a year (HR, 1.25 1.08‒1.44). Conclusions Residence in socioeconomically disadvantaged communities predicts rehospitalization and mortality. Measuring neighborhood deprivation can identify individuals at risk following cardiac hospitalization.