Health & place
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Neighborhood environment and cognitive function in older adults: A multilevel analysis in Hong Kong.
In considering the influence of the neighborhood environment on cognitive function, little research has looked beyond the individual factors. Here, we conducted a study on 21,008 older adults aged 65 years and above in Hong Kong to examine the cross-sectional associations of neighborhood economic disadvantage, recreational resources, walkability, library accessibility and physical activities on cognitive function and dementia. Both smaller and larger census tracts were adopted as proxies for neighborhoods. ⋯ No significant interaction effect was identified except on the educational level and neighborhood library accessibility. To conclude, late life residential environments are important contexts for aging. Aging-in-place interventions in Hong Kong should thus address neighborhood poverty, improve accessibility of libraries and walkability to reduce future risks of cognitive decline.
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Historical practices, such as housing discrimination in Detroit, have been shown to have lasting impacts on communities. Perhaps the most explicit example is the practice of redlining in the 1930s, whereby lenders outlined financially undesirable neighborhoods, populated by minority families, on maps and prevented residents from moving to better resourced neighborhoods. Awareness of historical housing discrimination may improve research assessing the impacts of current neighborhood characteristics on health. ⋯ Stratum-specific foreclosure recovery effects indicate stronger influence in neighborhoods with a greater proportion of residents identifying as white and a greater degree of historic redlining. These findings support earlier theory suggesting a historical influence of structural discrimination on the association between current neighborhood characteristics and health, and suggests that historical redlining specifically may increase vulnerability to contemporary neighborhood foreclosures. Community interventions should consider historical discrimination in conjunction with current place-based indicators to more equitably improve population health.
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As the world comes closer to the eradication of polio, the question of preparing for life after this debilitating disease becomes increasingly pertinent. This paper focuses on on-going institutional attempts to conceptualise, plan, and deliver a world after polio. Drawing upon interviews with global health officials and ethnographic fieldwork with eradication initiatives in Nigeria and Pakistan, I explore how international donors are transitioning towards life after the disease and the curtailment of the substantial resources it has successfully mobilised. Focusing specifically on the wind-down of the Global Polio Eradication Initiative, I critically examine key risks emerging from polio transition and highlight a series of spatial and political assumptions about the emergent post-polio contours of global health that have largely been obscured by attempts to render transition planning as little more than a technical exercise.
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Cross-sectional studies of Alzheimer's disease tend to report higher risk in 'rural' areas. Multilevel longitudinal analysis of 261,669 participants in the Sax Institute's 45 and Up Study was conducted, tracking incidence of Alzheimer's disease defined by the first cholinesterase inhibitor prescription via linked records from the Department of Human Services in Australia. ⋯ Adjusting for age, gender, education, income and area disadvantage, Alzheimer's disease risk was lower in 'outer regional and remote areas' (incident rate ratio 0.81, 95%CI 0.67-0.97) compared with 'major cities'. Further research on environmental factors is warranted.
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To investigate the possible effects of middle and high school racial composition on later reporting of lifetime non-medical use of prescription painkillers (NMUPP) in young adulthood, and to explore whether there is evidence of variability by individual race/ethnicity in such effects. ⋯ We found evidence of an effect of school racial composition on the risk of misusing prescription painkillers over a decade later, over and above individual race, with higher risk of misuse reported among participants who had attended white schools. Black participants who had attended predominantly white schools were, on average, twice as likely to report lifetime misuse of prescription painkillers compared to blacks who had attended black schools.